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)

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)

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)

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)

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)

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)

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)

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)

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)

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.

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)

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)

I begin by examining how genetics drivesschizophrenia research, and raise both familiar andrelatively novel criticisms of the evidence putativelysupporting the genetic basis of schizophrenia. Inparticular, I call attention to a set of concernsabout the effects of placentation on concordance ratesof schizophrenia in monozygotic twins, which furtherweakens the case for schizophrenia''s so-called stronggenetic component. I then underscore two criticalpoints. First, I emphasize the importance of takingseriously considerations about the complexity of bothontogenesis and the development of hereditarydiseases. The recognition (...) of developmentalconstraints and supports is crucial, for attention todevelopment exposes the naivete of too many models ofgene action in the aetiology of disease. Secondly, Iattend to those schizophreniologists who ignoremethodological criticisms and thus presume a geneticbasis for schizophrenia, and then seek the schizophrenic genotype lacking an adequatephenotype. In response I attempt to demonstrate thenecessity of a sustained effort at characterizing thephenotype of schizophrenia as an enabling conditionfor the whole enterprise of psychiatric genetics – andfor psychiatry itself. Without the organism-levelphenotype, research at the level of genes will remainunproductive – assuming of course that research at thegenetic level is appropriate at all. (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)

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)

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)

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)

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)

Schizophrenia is a worldwide, prevalent disorder with a multifactorial but highly genetic aetiology. A constant prevalence rate in the face of reduced fecundity has caused some to argue that an evolutionary advantage exists in unaffected relatives. Here, I critique this adaptationist approach, and review – and find wanting – Crow's “speciation” hypothesis. In keeping with available biological and psychological evidence, I propose an alternative theory of the origins of this disorder. Schizophrenia is a disorder of the social brain, (...) and it exists as a costly trade-off in the evolution of complex social cognition. Paleoanthropological and comparative primate research suggests that hominids evolved complex cortical interconnectivity (in particular, frontotemporal and frontoparietal circuits) to regulate social cognition and the intellectual demands of group living. I suggest that the ontogenetic mechanism underlying this cerebral adaptation was sequential hypermorphosis and that it rendered the hominid brain vulnerable to genetic and environmental insults. I argue that changes in genes regulating the timing of neurodevelopment occurred prior to the migration of Homo sapiens out of Africa 100,000–150,000 years ago, giving rise to the schizotypal spectrum. While some individuals within this spectrum may have exhibited unusual creativity and iconoclasm, this phenotype was not necessarily adaptive in reproductive terms. However, because the disorder shared a common genetic basis with the evolving circuitry of the social brain, it persisted. Thus schizophrenia emerged as a costly trade-off in the evolution of complex social cognition. Key Words: cortical connectivity; evolution; heterochrony; metarepresentation; primates; psychiatry; schizophrenia; social brain; social cognition. (shrink)

Dysfunctions of the neural circuits that implement social behavior are necessary but not a sufficient condition to develop schizophrenia. We propose that schizophrenia represents a disease of general connectivity that impairs not only the “social brain” networks, but also different neural circuits related with higher cognitive and perceptual functions. We discuss possible mechanisms and evolutionary considerations.

The paper attempts to account for the confusion over the validity of the concept of schizophrenia in terms of two closely related aspects of conceptual indeterminacy. Firstly, it is identified on the basis of a breakdown in intelligibility, but what constitutes such a breakdown is indeterminate. Secondly, the concept sits between the categories of natural disease or illness on the one hand, and character trait or moral failing or gift on the other. This entails an indeterminacy in attempting to (...) define the role that physiological explanation could have. Light may be thrown on the concept by exploring a distinction between a life story in which the schizophrenic condition emerges as the conclusion of the story and a causal process in which the condition is the end result or final consequence. (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)

The work of Professor Kraus is more than welcome at a time in which Psychopathology has become increasingly shallow and lacking in density, content with the role of an ideal “observer” whose only ambition is an objective description of signs and symptoms in order to fulfil operational criteria which reliably bestow a place for the case under observation within the grid of diagnostic classification.

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.

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)

Current thinking suggests that dissociation could be a significant comorbid diagnosis in a proportion of schizophrenic patients with a history of trauma. This potentially may explain the term “schizophrenia” in its original definition by Bleuler, as influenced by his clinical experience and personal view. Additionally, recent findings suggest a partial overlap between dissociative symptoms and the positive symptoms of schizophrenia, which could be explained by inhibitory deficits. In this context, the process of dissociation could serve as an important (...) conceptual framework for understanding schizophrenia, which is supported by current neuroimaging studies and research of corollary discharges. These data indicate that the original conception of “split mind” may be relevant in an updated context. Finally, recent data suggest that the phenomenal aspects of dissociation and conscious disintegration could be related to underlying disruptions of connectivity patterns and neural integration. (shrink)

This paper provides a concise description and discussion of bottom–up and top–down approaches to misattribution of agency in schizophrenia. It explores if first-person accounts of passivity phenomena can provide support for one of these approaches. The focus is on excerpts in which the writers specifically examine their experiences of external influence. None of the accounts provides arguments that fit easily with only one of the possible approaches, which is in line with current attempts to theoretical integration.

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)

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)

We present a study of the linguistic output of the German-speaking writer Robert Walser using Natural Language Processing (NLP). We curated a corpus comprising texts written by Walser during periods of sound health, and writings from the year before his hospitalization, and writings from the first year of his stay in a psychiatric clinic, all likely attributed to schizophrenia. Within this corpus, we identified and analyzed a total of 20 linguistic markers encompassing established metrics for lexical diversity, semantic similarity, (...) and syntactic complexity. Additionally, we explored lesser-known markers such as lexical innovation, concreteness, and imageability. Notably, we introduced two additional markers for phonological similarity for the first time within this context. Our findings reveal significant temporal dynamics in these markers closely associated with Walser’s contemporaneous diagnosis of schizophrenia. Furthermore, we investigated the relationship between these markers, leveraging them for classification of the schizophrenic episode. (shrink)

The mutual interest between embodied cognitive sciences, in particular enactivism, and phenomenological psychopathology has significantly increased in the last 15 years. Gipps's article contributes to this field of research by defining ego boundaries in an enactivist framework to explain how the distinction self-other emerges and is maintained in ordinary healthy conditions, and how it is weakened and impaired in cases of schizophrenia. Gipps's first tenet is: The ego-boundary is enacted equiprimordially with experience, that is, it...

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 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) 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)

Published in 1972, Anti‐Oedipus was the first of a number of collaborative works between the French philosopher, Gilles Deleuze, and the French psychoanalyst and political activist, Felix Guattari. As the first of a two‐volume body of work that bears the subtitle, Capitalism and Schizophrenia, Anti‐Oedipus is, to say the least, an unconventional work that should be understood, in part, as a product of its time – created as it was among the political and revolutionary fervour engendered by the events (...) of ‘May 1968’. However, this paper will suggest that Anti‐Oedipus – as a critique of psychoanalysis and the Oedipus complex, as well as being a study of the relationship between capitalism and schizophrenia – should also be understood in a less ‘time‐bound’ fashion. In particular, the paper will examine Deleuze and Guattari’s formulation of a concept of ‘desire’ and its employment in relation to subjectivity, time, capitalism, representation, and the radical ‘therapeutic’ practice that they refer to as ‘schizoanalysis’. Moreover, nearly 40 years after the events of May 1968 and against possible doubts concerning the contemporary relevance of psychoanalysis, it will be suggested that psychoanalysis and the Oedipus complex are to be understood as symptomatic of a wider ‘malaise’ that can be discerned within psychiatry, psychotherapy, and contemporary capitalist society itself, and that it is this that forms the broader target of the book’s critique. Accordingly, by providing an accessible and critical introduction to Anti‐Oedipus, the paper also hopes to stimulate further discussion and research regarding both the critique and the contribution that the work can make to contemporary psychiatry, psychotherapy, and mental health nursing generally. (shrink)

Extant philosophical accounts of schizophrenic alien thought neglect three clinically signifi cant features of the phenomenon. First, not only thoughts, but also impulses and feelings, are experienced as alien. Second, only a select array of thoughts, impulses, and feelings are experienced as alien. Th ird, empathy with experiences of alienation is possible. I provide an account of disownership that does justice to these features by drawing on recent work on delusions and selfknowledge. Th e key idea is that disownership occurs (...) when there is a failure of rational control over one’s mind. Th is produces a clash between the deliverances of introspection and practical enquiry as ways of knowing one’s mind. Th is explanation places disownership on a continuum with more common aspects of our psychological life, such as addiction, akrasia, obsessional thinking, and immoral, selfi sh or shameful thoughts. I conclude by addressing objections, and exploring the relevance of my account to questions in the philosophy of psychiatry concerning the validity of our current taxonomy of symptoms, and the nature of psychiatric classifi cation.. (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)

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.

Evolutionary psychiatrists invariably consider schizophrenia to be a paradox: how come natural selection has not yet eliminated the infamous ‘genes for schizophrenia’ if the disorder simply crushes the reproductive success of its carriers, if it has been around for thousands of years already, and if it has a uniform prevalence throughout the world? Usually, the answer is that the schizophrenic genotype is subject to some kind of balancing selection: the benefits it confers would then outbalance the obvious damage (...) it does. In this paper, however, I will show that the assumptions underlying such evolutionary accounts of schizophrenia are at least implausible, and sometimes even erroneous. First of all, I will examine some factual assumptions, in particular about schizophrenia’s impact on reproductive success, its genetics, its history, and its epidemiology. Secondly, I will take a critical look at a major philosophical assumption in evolutionary psychiatric explanations of schizophrenia. Indeed, evolutionary psychiatrists take it for granted that schizophrenia is a natural kind, i.e. a bounded and objectively real entity with discrete biological causes. My refutation of this natural kind view suggests that schizophrenia is in fact a reified umbrella concept, covering a heterogeneous group of disorders. Therefore, schizophrenia, as we now know it, simply doesn’t have an evolutionary history. (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 the past dozen years a number of theoretical models of schizophrenic symptoms have been proposed, often inspired by advances in the cognitive sciences, and especially cognitive neuroscience. Perhaps the most widely cited and influential of these is the neurocognitive model proposed by Christopher Frith (1992). Frith's influence reaches into psychiatry, neuroscience, and even philosophy. The philosopher John Campbell (1999a), for example, has called Frith's model the most parsimonious explanation of how self-ascriptions of thoughts are subject to errors of identification. (...) "On reflection, it also seems that this is not just one possible theory; it is the simplest theory which has any prospect of explaining the sense of agency, and we ought to work from it, introducing complications only as necessary" (1999a, p. 612). Not everyone agrees. In their recent analysis of alien voices and inserted thoughts in schizophrenia, Stephens and Graham (2000) offer a critique of Frith. Their criticism, however, although serious, is neither deep nor extensive. They outline three points. First, Frith fails to provide an adequate account of why a subject who experiences thought insertion would misattribute that thought to some other agent. Second, Frith does not clarify the distinction between thought insertion and thought influence. And third, Frith fails to explain how a subject can claim both that he is thinking the thought and that the thought is someone else's thought (Stephens and Graham.. (shrink)

Emerging evidence is now challenging the view that patients diagnosed with schizophrenia experience a selective deficit in their sense of agency. Additional disturbances seem to exist in their sense of body ownership. However, the factors underlying this disturbance in body ownership remain elusive. Knowledge of these factors, and increased understanding of how body ownership is related to other abnormalities seen in schizophrenia, could ultimately advance development of new treatments. Research on body ownership in schizophrenia has mainly been (...) investigated with the rubber hand illusion (RHI). Schizophrenia patients show higher susceptibility to the RHI, which may be explained by a stronger reliance on multisensory information over weaker stored body representations. This review shows that a coherent sense of body ownership arises from the integration of both bottom-up sensory processes and higher order, top-down bodily- and perceptual representations. Multisensory integration, temporal binding, anticipation, intention and efferent signals all partly modulate the complex experience of body ownership. Specifically, we propose that patients with schizophrenia have weaker stored body representations, and rely to a greater extent on external stimuli, such as visual information, due to imprecise or highly variable internal predictions on the consequences of action. Moreover, the reduced sense of agency in schizophrenia may additionally contribute to the disturbed sense of body ownership, as evidence from healthy participants suggests that agency and body ownership are interrelated. Vice versa, a reduced sense of body ownership may also contribute to a reduced sense of agency. Future studies should explicitly target the precise relation between the two in schizophrenia. (shrink)