Do self‐monitoring accounts, a dominant account of the positive symptoms of schizophrenia, explain auditory verbal hallucination? In this essay, I argue that the account fails to answer crucial questions any explanation of auditory verbal hallucination must address. Where the account provides a plausible answer, I make the case for an alternative explanation: auditory verbal hallucination is not the result of a failed control mechanism, namely failed self‐monitoring, but, rather, of the persistent automaticity of auditory experience of a voice. My (...) argument emphasizes the importance of careful examination of phenomenology as providing substantive constraints on causal models of the positive symptoms in schizophrenia. (shrink)

Many with schizophrenia find social interactions a profound and terrifying threat to their sense of self. To better understand this we draw upon dialogical models of the self that suggest that those with schizophrenia have difficulty sustaining dialogues among diverse aspects of self. Because interpersonal exchanges solicit and evoke movement among diverse aspects of self, many with schizophrenia may consequently find those exchanges overwhelming, resulting in despair, the sensation of fusion with another, and/or self-dissolution. In short, compromised (...) dialogical capacities may be a contributing factor to social dysfunction in schizophrenia. (shrink)

First published in 1976, Schizophrenia: The Sacred Symbol of Psychiatry examines the concept of schizophrenia and the origins of its classification as a disease. Szasz convincing argues that rather than a medical diagnosis, the word schizophrenia is a symbol employed by psychiatrists as a means of control.

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)

Phillips & Singer's compelling presentation is weakest in its demonstration of commonalities between sensory plasticity and higher forms of learning and behavior. We propose that available data on schizophrenia can provide such evidence, because of the presence of impairments in a number of functions central to their model, and strong relationships between these dysfunctions and behavior.

A family of recent externalist approaches in philosophy of mind argues that our psychological capacities are synchronically and diachronically “scaffolded” by external resources. I consider how these “scaffolded” approaches might inform debates in phenomenological psychopathology. I first introduce the idea of “affective scaffolding” and make some taxonomic distinctions. Next, I use schizophrenia as a case study to argue—along with others in phenomenological psychopathology—that schizophrenia is fundamentally a self-disturbance. However, I offer a subtle reconfiguration of these approaches. I argue (...) that schizophrenia is not simply a disruption of ipseity or minimal self-consciousness but rather a disruption of the scaffolded self, established and regulated via its ongoing engagement with the world and others. I conclude by considering how this scaffolded framework indicates the need to consider new forms of intervention and treatment. (shrink)

Recent debates concerning the abolition of the schizophrenia label in psychiatry have focused upon problems with the scientific status of the concept. In this article, I argue that rather than attacking schizophrenia for its lack of scientific validity, we should focus on the conceptual history of this label. I reconstruct a specific tradition when exploring the conceptual history of schizophrenia. This is the concern with the question of the sense of life itself, conducted through the confrontation with (...) schizophrenia as a form of life that does not live, or as Robert Jay Lifton termed it ‘lifeless life’ (1979: 222—39). I conclude by arguing that the contemporary attempt to deconstruct or abolish the schizophrenia concept involves a fundamental shift in concern. The attempt both to normalize psychotic experiences, and to conceive them purely in terms of cognitive processes that can be mapped onto brain function, results in a fundamental move away from the attempt to understand the experience of madness. (shrink)

Considerable evidence from preclinical and clinical investigations implicates disturbances of brain dopamine (DA) function in the pathophysiology of several psychiatric and neurologic disorders. We describe a neural model that may help organize theseindependent experimental observations. Cortical regions classically associated with the limbic system interact with infracortical structures, including the nucleus accumbens, ventral pallidum, and dorsomedial nucleus of the thalamus. In our model, overactivity in forebrain DA systems results in the loss of lateral inhibitory interactions in the nucleus accumbens, causing disinhibition (...) of pallidothalamic efferents; this in turn causes rapid changes and a loss of focused corticothalamic activity in cortical regions controlling cognitive and emotional processes. These effects might be manifested clinically by some symptoms of psychoses. Underactivity of forebrain DA results in excess lateral inhibition in the nucleus accumbens, causing tonic inhibition of pallidothalamic efferents; this perpetuates tonic corticothalamic activity and prevents the initiation of new activity in other critical cortical regions. These effects might be manifested clinically by some symptoms of depression. This model parallels existing explanations for the etiology of several movement disorders, and may lead to testable inferences regarding the neural substrates of specific psychopathologies. (shrink)

Temporal experience and its radical alteration in schizophrenia have been one of the central objects of investigation in phenomenological psychopathology. Various phenomenologically oriented researchers have argued that the change in the mode of temporal experience present in schizophrenia can foreground its psychotic symptoms of delusion. This paper aims to further the development of such a phenomenological investigation by highlighting a much-neglected aspect of schizophrenic temporal experience, i.e., its non-emotional affective characteristic. In this paper, it denotes the type of (...) an experience wherein an afflicted individual experiences a pervasive pull or attraction coming from the past, present, and future. By employing Husserl’s account of affection, I argue that such an affectively prominent temporal experience is not yet another abnormality that happens to be present in schizophrenia. Instead, it is indicative of the core disturbance that underpins the schizophrenic temporal mode of experience. I identify such a disturbance as ‘affective modification dysfunction’ and employ it as a core concept with which I synthesize and organise heterogeneous components of schizophrenic temporal experience in their conceptual unity. For the sake of clear description, I organise those components into the following categories: 1.) Time Stop 2.) Ante-festum 3.) Déjà vu/vécu and 4.) Time Fragmentation. I conclude by demonstrating how approaching schizophrenic temporal experience from its affective dimension can further help us better understand its pre-psychotic phase known to precipitate schizophrenic primary delusion, i.e., delusional mood. (shrink)

Schizophrenia is a mental disorder that calls the mineness of one's own sensations, thoughts and actions into question and threatens the person with a loss of self. In order to understand this illness in its essence, an approach based on phenomenological psychopathology is therefore indispensable. Conversely, disorders of the self in schizophrenia should be of crucial interest for any philosophy of subjectivity in order to test its concepts of self-awareness, personhood and intersubjectivity by reference to empirical phenomena.Contemporary neurobiological (...) concepts of schizophrenia predominantly emphasize the importance of impaired integration of somatosensory inputs into stable central-nervous representations... (shrink)

A new etiological model is proposed for schizophrenia that combines variability‐enhancing nonspecific factors acting during development with more specific risk factors. This model is better suited than the current etiological models of schizophrenia, based on the risk factors paradigm, for predicting and/or explaining several important findings about schizophrenia: high co‐morbidity rates, low specificity of many risk factors, and persistence in the population of the associated genetic polymorphisms. Compared with similar models, e.g., de‐canalization, common psychopathology factor, sexual‐selection, or (...) differential sensitivity to the environment, this proposal is more general and integrative. Recently developed research methods have proven the existence of genetic and environmental factors that enhance developmental variability. Applying such methods to newly collected or already available data can allow for testing the hypotheses upon which this model is built. If validated, this model may change the understanding of the etiology of schizophrenia, the research models, and preventionbrk paradigms. (shrink)

With ever more detailed models of the neurobiological and social systems out of which schizophrenia is born, it is possible to overlook how suffering persons actually experience their symptoms.This book examines the experiences of persons who suffer from schizophrenia. It provides a highly readable and humane examination of this common condition.

This article examines the supposedly incomprehensibility of schizophrenic delusions. According to the contemporary classificatory systems (DSM-IV-TR and ICD-10), some delusions typically found in schizophrenia are considered bizarre and incomprehensible. The aim of this article is to discuss the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that (...) the notion of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning in terms of motivations, desires, and other more straightforward psychological connections between mental states is impossible in schizophrenia, we can in fact have a philosophical understanding of the schizophrenic world and of the emergence of delusions typically found in schizophrenia. (shrink)

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,”, 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... (shrink)

Schizophrenia has been investigated predominately from psychological, psychiatric and neurobiological perspectives. This book is unique in examining it from a philosophical point of view. It should appeal to every reader who wants to better understand this major mental illness, providing unique insights into the 'experience' of schizophrenia.

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study (...) of schizophrenia and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

. Progress in technology has allowed dynamic research on the development of the human brain that has revolutionized concepts. Particularly, the notions of plasticity, neuronal selection, and the effects of afferent stimuli have entered into thinking about brain development. Here I focus on development from the age of four years to early adulthood, during which a 30 percent reduction in some brain synapses occurs that is out of proportion to changes in neuronal numbers. This corresponds temporally with changes in normal (...) child behavior from the loose‐associative, almost schizoid, thinking and art of the four‐year‐old to the more trained, or disciplined, or acculturated—and restrained—personality of the young adult. I propose that the synaptic changes can best be thought of as a winnowing process likely subject to environmental influences. Acquisition of language and the ability to link linguistic cognition to the plastic development of the brain provide a potentially powerful means of explaining the evolutionally explosive development of human cognition and culture. Schizophrenia, a disease that can be envisioned as representing a derangement of synaptic maturation, may provide an entry into the search for genes controlling the processes mediating the unprecedented development of Homo sapiens over the past 40,000 to 70,000 years. The recently completed mapping of the genome of the chimpanzee provides a new frame of reference that may speed the search. (shrink)

In this paper, I give a Kantian answer to the question whether and why it would be inappropriate to blame people suffering from mental disorders that fall within the schizophrenia spectrum. I answer this question by reconstructing Kant’s account of mental disorder, in particular his explanation of psychotic symptoms. Kant explains these symptoms in terms of various types of cognitive impairment. I show that this explanation is plausible and discuss Kant’s claim that the unifying feature of the symptoms is (...) the patient’s inability to enter into an exchange of reasons with others. After developing a Kantian Quality of Will Thesis, I analyze some real life cases. Firstly, I argue that delusional patients who are unable to enter into an exchange of epistemic reasons are exempted from doxastic rather than moral responsibility. They are part of the moral community and exonerated from moral blame only if their actions do not express a lack of good will. Secondly, I argue that disorganized patients who are unable to form intentions and to make plans are exempted from moral responsibility because they do not satisfy the conditions for agency. (shrink)

Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients’ conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious (...) and conscious level.We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness. (shrink)

Neuroimaging techniques have made a huge contribution to our understanding of schizophrenia and other neuropsychiatric disorders. Until now however, texts on both schizophrenia and neuroimaging have paid little attention to the overlap between these areas. This new volume is the first dedicated to unravelling how these techniques can help us better understand this complex disorder. Each chapter focuses on a particular research method, describing the nature of the findings, the main technological problems, and future possibilities. Though including sufficient (...) methodological detail to be of value to imaging researchers, the emphasis throughout is on providing information of value to clinicians. Written and edited by leaders in schizophrenia research, this book details what structural and functional brain imaging studies have already established about schizophrenia and what developments are likely in the foreseeable future. (shrink)

Merleau-Ponty finds a philosophical interest in the psychoanalytical clinic, especially in the the clinic of children and hallucinating people, which can support the concepts of flesh and Ineinander. But in the philosophy of Merleau-Ponty there is also a clinical interest, residing in the link he establishes between the flesh, conceived as the origin of existence, and the pathologies that Freud described as “narcissistic” and nowadays called “psychotic” or “borderline” states. To support this hypothesis, we will link Merleau-Ponty’s own “clinic of (...) the origins” and Harold Searles’ theory of narcissistic pathologies based on his clinical experience with schizophrenics. This confrontation will reveal how a philosophy of flesh provides us not only with theoretical points of reference relevant to the clinic of schizophrenia, but also fruitful technical indications regarding the direction towards a cure of such a pathology, indications that join those provided by Searles. (shrink)

The title of this book is particularly significant in that Dr. Rushdoony was able to identify the basic contradiction that pervades a secular society that rejects God's sovereignty by still needs law and order, justice, science, and meaning to life. Secular man wants to use the thinks of creation while denying their creator. As Dr. Rushdoony writes, 'there is no law, no society, no justice, no structure, no design, no meaning apart from God.' And so, modern man has become schizophrenic. (...) He wants to assert his autonomy while rejecting the divine order that gives meaning to life. To the humanist, the aim of living is something he calls the 'good life.' For the nihilist, it is violence and death. Dr. Rushdoony saw cultural schizophrenia as a split between thought and feeling, a withdrawal from the reality of God and a flight into fantasies of world government achieved through an unattainable unity. Utopians are undeniably schizophrenic. They want a heaven on earth, which can only be achieved by coercion and enslavement. But perhaps what they really want, as depraved human beings, is coercion and enslavement, and use utopian idealism to deceive and entrap the gullible. Nor is it by accident that the government schools now lavish so much time on death education, which has been marbleized throughout the curriculum. As Dr. Rushdoony writes: 'For man to turn his back on God, therefore, is to turn towards death.' And this is exactly what the government schools have done. Add to this, multiculturalism, transcendental meditation, sensitivity training, explicit sex education, drug education, evolution, behavioral psychology, humanism, whole language, and other such programs, and you get a curriculum that is so profoundly anti-Christian that one wonders how any Christian parent or minister can condone putting a Christian child in a government school from the forward by Samuel L. Blumenfeld. (shrink)

Despite the diagnostic relevance of thought insertion for disorders such as schizophrenia, the debates about its aetiology are far from resolved. This paper claims that in paying exclusive attention to the perceptual and cognitive impairments leading to delusional experiences in general, current deficit approaches overlook the role that affective disturbances might play in giving rise to cases of thought insertion. In the context of psychosis, affective impairments are often characterized as a consequence of the stress and anxiety caused by (...) delusional episodes. However, here I explore some of the conceptual and empirical reasons to think that affective problems might in fact play a crucial doxastic role in the aetiology of thought insertion. Finally, I conclude by proposing a way of integrating the main insights of my analysis with the current ‘two-factor’ deficit approach to thought insertion and I explore the potential adaptive role that some delusions might have within this framework. (shrink)

The repeatedly noted absence of case-reports of individuals with schizophrenia and congenital/early developed blindness has led several authors to argue that the latter can confer protective effects against the former. In this work, we present a number of relevant case-reports from different syndromes that show comorbidity of congenital and early blindness with schizophrenia. On the basis of these reports, we argue that a distinction between different types of blindness in terms of the origin of the visual deficit, cortical (...) or peripheral, is crucial for understanding the observed patterns of comorbidity. We discuss the genetic underpinnings and the brain structures involved in schizophrenia and blindness, with insights from language processing, laying emphasis on the three structures that particularly stand out: the occipital cortex, the lateral geniculate nucleus and the pulvinar. Last, we build on previous literature on the nature of the protective effects in order to offer novel insights into the nature of the protection mechanism from the perspective of the brain structures involved in each type of blindness. (shrink)

While schizophrenia may be genetically determined up to a point, neither it nor its nearest relatives offer any sort of reproductive advantage to its sufferers. Instead, from an evolutionary point of view, schizophrenia is benign – it neither promotes nor inhibits survival to reproduction. Because it is benign, its rate of occurrence should remain fairly constant over time.

Schizophrenia in adolescents and the family system Empirical research shows that chronic diseases have specific, idiosyncratic functions in the family, and give real, psychosocial advantages. This leaves the question - can schizophrenic disorders have similar function in the family system as a chronic somatic disease? We have analyzed systemic family traits in families with schizophrenic young patients. The reference samples were two kinds of families: families with schizophrenic adults and families without any chronic disease or chronic illness. The subjects (...) of analysis were coefficients of the systemic features, identified by factor analysis according to author's proposal. Oneway Anova was used to compare indexes between three groups of families. The results show that mental disorder in adolescents participates in the life of the whole family, having similar functions to the functions of chronic somatic diseases. They also suggest that, from the family members' point of view, schizophrenic disorders in a teenagers has different quality compared to schizophrenic disorders in an adult. (shrink)

A diagnosis of schizophrenia is often taken to denote a state of global irrationality within the psychiatric paradigm, wherein psychotic phenomena are seen to equate with a lack of mental capacity. However, the little research that has been undertaken on mental capacity in psychiatric patients shows that people with schizophrenia are more likely to experience isolated, rather than constitutive, irrationality and are therefore not necessarily globally incapacitated. Rational suicide has not been accepted as a valid choice for people (...) with schizophrenia due in part to a belief that characteristic irrationality prevents autonomous decision-making. Since people with schizophrenia are often seen to lack insight into the nature of their disorder, both psychiatric and ethical perspectives generally presume that suicidal acts result directly from mental illness itself and not from second-order desires. In this article, I challenge notions of global irrationality conferred by a diagnosis of schizophrenia and argue that, where delusional beliefs are unifocal, schizophrenia does not necessarily lead to a state of mental incapacity. I then attempt to show that people with schizophrenia can sometimes be rational with regard to suicide, where this decision stems from a realistic appraisal of psychological suffering. (shrink)

Traditionally, phenomenological theories of schizophrenia have emphasized disturbances in self-experience, with relatively little acknowledgement of the surrounding world. However, epidemiological research consistently demonstrates a strong relationship between traumatic and stressful life events and the development of schizophrenia, suggesting that encounters in the world are highly relevant for many people diagnosed with this disorder. This paper reviews foundational texts in phenomenology and phenomenological psychopathology on the nature of subjectivity and its disturbances, finding support for broadening contemporary phenomenological models of (...) schizophrenia to incorporate world events and their subjective meaning as essential aspects of this disorder. This contextual approach to phenomenology emphasizes the relationship between self and world, one that is especially unstable, unclear, and untrustworthy in schizophrenia. Both epidemiological and phenomenological research can benefit from this approach: in epidemiology, researchers might consider the ways that various risk factors are experienced by persons vulnerable to schizophrenia, while phenomenologists are encouraged to inquire about the environmental and social context in which altered experiences occur and incorporate these considerations into their explanatory models. (shrink)

This is a commentary on Humpston, C. S. (2022). “Isolated by Oneself: Ontologically Impossible Experiences in Schizophrenia.” Philosophy, Psychiatry, & Psychology 29(1), 5–15. It is published with an additional commentary by H. Green and Humpston’s response.

In various ways, schizophrenia seems to involve an anomalous form of collective intentionality. Many patients report notable difficulties in establishing and maintaining relationships to others, which often may lead to social withdrawal, isolation, and pro-found feelings of solitude. What is puzzling is of course not that patients, despite their interpersonal difficulties, participate in or try to participate in various social activities, but that some of these social activities appear quite tolerable to the patients, whereas other activities seem almost unbearable. (...) The aim of this paper is to shed light on this aberrant social behaviour by clarifying the relations between schizophrenia and collective intentionality. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 339-341 [Access article in PDF] Schizophrenia and Self-Awareness Dan Zahavi In his paper, "Cogito and I: A Bio-Logical Approach," Kimura Bin raises a number of intriguing issues. Let me in the following address a few of them. Kimura Bin's point of departure is the idea that schizophrenia is basically to be understood as a disorder of self and self-experience. Thus, fundamental (...) alterations in the sense of possession and control of one's own thoughts, actions, sensations, or emotions figure among the most prominent symptoms in its advanced stages. But even in the absence of overt symptoms, the schizophrenic may feel uncertain about her selfhood, and it is often in an attempt to restore or at least sustain her precarious self-identity that the patient engages in characteristic obsessive self-reflections that frequently simply exacerbate the problem.1. One way to illustrate what is peculiar about the self-disorder in schizophrenia is by contrasting it with the symptoms found in senile dementia. Whereas the demented patient might lack any knowledge about the features that characterize him from a third-person perspective, i.e., age, nationality, profession, location, etc., he is usually in possession of an intact first-person perspective: He is still aware of the I-Here-Now. In schizophrenia, the problem is typically exactly the reverse (Tatossian 1997, 26). This contrast makes it tempting to argue, as Kimura Bin in fact does, that we need to distinguish two different dimensions of selfhood: the self as subject and the self as object. Of course, by making that distinction, we are immediately partaking in a classical philosophical discussion. Thus, at least since Kant, it has been customary to distinguish between the transcendental subject and the empirical or mundane subject. This distinction can be cashed out as a distinction between two different ways of being aware of oneself, one external, the other internal. On the one hand, I can think of myself from a third-person perspective, that is, I can refer to an object by way of a proper name, a demonstrative, or a definite description, and occasionally this object happens to be myself. When I refer to myself in this way, I am referring to myself in exactly the same way that I can refer to Others, and Others can refer to me (the only difference being that I am the one doing it, thus making the reference into a kind of self-reference). Apart from being external and contingent, this kind of self-reference is also non-thematic, since it can occur without my knowledge of it, that is, I can refer to myself from the third-person perspective without realizing that I myself am the referent. In contrast, the self-reference available from the first-person perspective—the one expressed in the subject-use of "I"—is of an internal kind. Not only is it impossible to refer to anybody and anything apart from oneself in the first-person way, but it also belongs to the proper use of "I" that one knows that one is referring to oneself. That is, apart from being internal and necessary, the self-reference in question is also of a thematic nature. In [End Page 339] more traditional terms: One can be conscious of oneself as an empirical object with mental properties, and one can be conscious of oneself as the subject of intentionality. Or again, one can be aware of oneself as a causally determined known object, as a part of the world, and one can be aware of oneself as a knowing subject, as—to paraphrase Wittgenstein—the limit of the world. In short, the difference between the empirical subject and the transcendental subject is closely linked to the difference between being aware of oneself as an object in the world and being aware of oneself as a subject for the world.Utilizing this distinction, it can be said that schizophrenia involves a disturbance on the transcendental level (this way of speaking would, by the way, be anathema to a classical Kantian transcendental philosophy but more acceptable to the... (shrink)

Ordinarily, if you say something like “I see a comet,” you might make a mistake about whether it is a comet that you see, but you could not be right about whether it is a comet but wrong about who is seeing it. There cannot be an “error of identification” in this case. In making a judgement like, “I see a comet,” there are not two steps, finding out who is seeing the thing and finding out what it is that (...) is being seen, so that you could go wrong at either step. The only place to go wrong is in your description of what is being seen. We usually take it that the same point applies to present-tense ascriptions to oneself of psychological states in general. You can get it wrong about which psychological state you are in, but you cannot get it right about the psychological state but wrong about whose psychological state it is. In contrast, in a room full of people, I might hear a noise and conclude, “Bill sneezed,” and in this case I could be wrong either about who it was that sneezed or about whether it was a sneeze, rather than say a death-rattle. (shrink)

For more than 20 years now, the phenomenological approach to schizophrenia has developed a strong and influential hypothesis on the basic alterations of this disorder. Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the minimal self. This ‘minimal self’ aims to describe the most basic or core self, which is considered to be foundational for every other kind of self. It is a form of minimal self-awareness that precedes every explicit or (...) reflective self-awareness. Based on this model, a semistructured interview has... (shrink)

Uttered language does not necessarily reflect the planned communications of schizophrenia patients, nor do their delusions necessarily reflect basic failures of inferential reasoning. The role of inhibitory failure in the production of speech and the role of primary experiences of discrepancy between intention and action, and between experience–based expectations and perceived realities account for many of the clinical phenomena that have led to the conclusion that these patients have a ‘thought’ disorder, or a ‘disturbed’ mind. The alternatives and the (...) evidence are summarized in this paper. (shrink)

Scientists, philosophers, and even the lay public commonly accept that schizophrenia stems from a biological or internal ‘dysfunction.’ However, this assessment is typically accompanied neither by well-defined criteria for determining that something is dysfunctional nor empirical evidence that schizophrenia satisfies those criteria. In the following, a concept of biological function is developed and applied to a neurobiological model of schizophrenia. It concludes that current evidence does not warrant the claim that schizophrenia stems from a biological dysfunction, (...) and, in fact, that unusual neural structures associated with schizophrenia may have functional or adaptive significance. The fact that current evidence is ambivalent between these two possibilities (dysfunction versus adaptive function) implies that schizophrenia researchers should be much more cautious in using the ‘dysfunction’ label than they currently are. This has implications for both psychiatric treatment as well as public perception of mental disorders. (shrink)

Schizophrenia (SCZ) is a severe neurodevelopmental disorder affecting 1% of populations worldwide with a grave disability and socioeconomic burden. Current antipsychotic medications are effective treatments for positive symptoms, but poorly address negative symptoms and cognitive symptoms, warranting the development of better treatment options. Further understanding of SCZ pathogenesis is critical in these endeavors. Accumulating evidence has pointed to the role of mitochondria and metabolic dysregulation in SCZ pathogenesis. This review critically summarizes recent studies associating a compromised mitochondrial function with (...) people with SCZ, including postmortem studies, imaging studies, genetic studies, and induced pluripotent stem cell studies. This review also discusses animal models with mitochondrial dysfunction resulting in SCZ‐relevant neurobehavioral abnormalities, as well as restoration of mitochondrial function as potential therapeutic targets. Further understanding of mitochondrial dysfunction in SCZ may open the door to develop novel therapeutic strategies that can address the symptoms that cannot be adequately addressed by current antipsychotics alone. (shrink)

Although context-processing deficits may be core features of schizophrenia, context remains a poorly defined concept. To test Phillips & Silverstein's model, we need to operationalize context more precisely. We offer several useful ways of framing context and discuss enhancing or facilitating schizophrenic patients' performance under different contextual situations. Furthermore, creativity may be a byproduct of cognitive uncoordination.

Chlorpromazine efficacy in schizophrenia was observed 60 years ago. Advances in pharmacotherapy of this disorder have been modest with effectiveness still limited to the psychosis psychopathology and mechanism still dependent on dopamine antagonism. While a look backward may generate pessimism, future discovery may be far more robust. The near future will see significant changes in paradigms applied in discovery. Rather than viewing schizophrenia as a disease entity represented by psychosis, the construct will be deconstructed into component psychopathology domains. (...) Each domain will represent a clinical target for aetiologic and therapeutic discovery. Research on pathophysiology will shift to the neural circuit level in relation to specific behavioural constructs. Progress at the molecular, genetic, cellular and network levels will be more robust. The behavioural paradigm will map on to the deconstructed clinical paradigm and in the process discovery will cut across current classification boundaries. (shrink)

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study (...) of schizophrenia and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 291-293 [Access article in PDF] Schizophrenia and the Void Jean Naudin and Jean-Michel Azorin It was Eugene Minkowski who, from the 1920s on, introduced the French to the work of Eugen Bleuler, whose student he had been. In the introduction to his first book, Schizophrenia: Psychopathology of Schizoids and Schizophrenics (Minkowski 1927), Minkowski nevertheless notes with regard to Bleuler that he (...) could not allow himself "to be restricted to this student's task." For Minkowski, Bleuler certainly enjoys the great merit of having substituted the notion of schizophrenia for that of dementia praecox and of having described autism with precision. But—Minkowski says—autism is badly defined when, relying upon the concept of Spaltung, Bleuler fails to break free of associationist psychology. Minkowski justifies his critical attitude by appealing, as does Binswanger, to Husserl and above all to Bergson. For Bergson, dissociation is a normal feature of thought. If, for Minkowski, it is important to pay attention to autism, it is because it attests not to a certain fragmentation of consciousness, but rather to an attitude whereby the subject seeks to preserve the precarious equilibrium of a personality that is threatened by a void.The article translated into English for this special issue of Philosophy, Psychiatry, & Psychology prefigures Schizophrenia and, like an earlier article on the theme of "morbid rationalism," already announces certain key concepts. Here these concepts are, so to speak, caught in their embryonic state, and one is forced to recognize with Tatossian (1993) how radically Minkowski differs from his master, Bleuler, in the choice of specific cases. By according exemplary significance to cases of "poor autism," Minkowski focuses on the reflexivity of the subjective experience of the patient rather than on the proliferation of the delusional state, which lends itself more readily to clinical observation. We must remember that Minkowski is above all a healer. If, like Bleuler, he is interested in the problem that generates the illness, it is only in order to be able to heal the patient. It is therefore not so much the isolated problem that interests him as the way the person tries to deal with it. So it should not come as a surprise that one of the essential themes of this article is what Minkowski calls "compensation." Like the psychoanalytical concepts to which Bleuler refers, compensation is a dynamic concept. But Minkowski takes care to distinguish the compensation that characterizes the interrogative attitude from motives of a more psychological kind aimed at meeting a lack by symbolically satisfying a desire. In the purely phenomenological sense in which Minkowski takes it, compensation does not refer to a hidden motive. It represents a way of getting around the void or sense of emptiness that results from the schizophrenic person's inability to project himself into the future by pursuing the practical goals of normal, daily life. In this case, the dynamic does not feed off the vicissitudes of drive but off the élan vital—or rather, off the decline of élan vital that such persons suffer. [End Page 291]Minkowski particularly insists upon the fact that Paul's interrogative attitude is not simple curiosity, even if Paul's questioning began with sexual curiosity. Confronted with incessant questioning reminiscent of a child, a psychoanalyst would be likely to invoke infantile curiosity concerning procreation and sexual difference. Minkowski, however, seeks to show that the prevailing motive in Paul's case is not so much desire for knowledge as the vital necessity of finding a way of—can one put it this way?—playing for time. In other words, the interrogatory attitude is a way of avoiding confrontation with the realm of practical concerns that, at bottom, makes the patient suffer. If this realm makes him suffer, it is because the absence of any vital attachment leaves him floating in a kind of void. The fundamental problem of schizophrenia is therefore identified as the loss of meaning going along with a deficiency in the individual's attachment to practical reality. Practical reality, or to put it otherwise, an orientation toward practical activity... (shrink)

In the USA and England and Wales, involuntary treatment for mental illness is subject to the constraint that it must be necessary for the health or safety of the patient, if he poses no danger to others. I will argue against this necessary condition of administering treatment and propose that the category of individuals eligible for involuntary treatment should be extended. I begin by focusing on the common disorder of schizophrenia and proceed to demonstrate that it can be a (...) considerable harm to a person's life without causing the person to be a danger to himself. I illuminate this claim by constructing a thought experiment concerning a person who slips on a banana peel and falls into a malfunctioning version of Robert Nozick's experience machine. I propose that the reasons why we should remove the person from the machine are the same reasons why we should administer involuntary treatment to individuals with schizophrenia. I rebut three objections to the analogy and conclude that if we believe that we have a duty to provide treatment for reasons relating to a person's wellbeing, it follows that we should reject the health or safety requirement and instead broaden the category of individuals who are eligible for involuntary treatment. (shrink)

This book explores the relationship between schizophrenia and common sense. It approaches this theme from a multidisciplinary perspective. Coverage features contributions from phenomenology, cognitive neuroscience, philosophy of mind, psychology, and social cognition. The contributors address the following questions: How relevant is the loss of common sense in schizophrenia? How can the study of schizophrenia contribute to the study of common sense? How to understand and explain this loss of common sense? They also consider: What is the relationship (...) of practical reasoning and logical formal reasoning with schizophrenia? What is the relationship between the person with a diagnosis of schizophrenia and social values? Chapters examine such issues as rationality, emotions, self, and delusion. In addition, one looks at brain structure and neurotransmission. Others explore phenomenological and Wittgensteinian theories. The book features papers from the Schizophrenia and Common Sense International Workshop, held at New University of Lisbon, November 2015. It offers new insights into this topic and will appeal to researchers, students, as well as interested general readers. (shrink)