Schizophrenia

I offer a new metacognitive account of the feeling of agency over bodily actions. On this model the feeling of agency is the metacognitive monitoring of two cues: i) smoothness of action: done via monitoring the output of the comparison between actual and predicted sensory consequences of action and ii) action outcome: done via monitoring the outcome of action and its success relative to a prior intention. Previous research has shown that the comparator model offers a powerful explanation of the (...) feeling of agency. However, within the literature there is a growing sense of unease with the model; a consensus seems to be building that the model is not up to the task of explaining all of the new discoveries made regarding the feeling of agency since its inception. Most problematically there are paradigms which deeply challenge the comparator model by suggesting that a weak feeling of agency can be elicited even when no motor prediction is formed. The new account offered here inherits the explanatory power of the comparator model whilst avoiding this problem. (shrink)

In this chapter, I introduce phenomenology and phenomenological psychopathology by clarifying the kind of implicit experiences that phenomenologists are concerned with. In section one, I introduce the phenomenological concept of pre-reflective experience, focusing especially on its relation to the concept of implicit experience. In section two, I introduce the structure of pre-reflective self-consciousness, which has been studied extensively by both classical phenomenologists and contemporary phenomenological psychopathologists. In section three, I show how phenomenological psychopathologists rely on an account of pre-reflective self-consciousness (...) to better understand the experience of schizophrenia and I outline some of the methodological challenges that arise in this field of research. This introduction should facilitate critical engagement and collaboration between phenomenologists and researchers working across a variety of disciplines, including psychology, psychiatry, the cognitive sciences, and analytic philosophy of mind. (shrink)

I discuss Watsuji’s characterization of aidagara or “betweenness”. First, I develop a phenomenological reading of aidagara. I argue that the notion can help illuminate aspects of our embodied subjectivity and its interrelation with the world and others. Along the way, I also indicate how the notion can be fruitfully supplemented by different sources of empirical research. Second, I put aidagara to work in the context of psychopathology. I show how disruptions of aidagara in schizophrenia not only affirm the foundational role (...) it plays in organizing our experience of self and world in everyday life. Additionally, I suggest the notion can, in this context of application, potentially enhance our understanding of and empathy for those living with schizophrenic disorders. (shrink)

In this comparative study, we examine experiential disruptions of embodiment and affectivity in Moebius Syndrome and schizophrenia. We suggest that using phenomenological resources to explore these experiences may help us better understand what it’s like to live with these conditions, and that such an understanding may have significant therapeutic value. Additionally, we suggest that this sort of phenomenologically-informed comparative analysis can shed light on the importance of embodiment and affectivity for the constitution of a sense of self and interpersonal relatedness (...) in normal conditions. (shrink)

We argue that a phenomenological approach to social space, as well as its relation to embodiment and affectivity, is crucial for understanding how the social world shows up as social in the first place—that is, as affording different forms of sharing, connection, and relatedness. We explore this idea by considering two cases where social space is experientially disrupted: Moebius Syndrome and schizophrenia. We show how this altered sense of social space emerges from subtle disruptions of embodiment and affectivity characteristic of (...) these conditions. These disruptions are instructive, we suggest, in that they highlight the foundational role that body and affect play in organizing social space—the lived context in which we first encounter one another as social agents. (shrink)

Wittgenstein’s concepts shed light on the phenomenon of schizophrenia in at least three different ways: with a view to empathy, scientific explanation, or philosophical clarification. I consider two different “positive” wittgensteinian accounts―Campbell’s idea that delusions involve a mechanism of which different framework propositions are parts, Sass’ proposal that the schizophrenic patient can be described as a solipsist, and a Rhodes’ and Gipp’s account, where epistemic aspects of schizophrenia are explained as failures in the ordinary background of certainties. I argue that (...) none of them amounts to empathic-phenomenological understanding, but they provide examples of how philosophical concepts can contribute to scientific explanation, and to philosophical clarification respectively. (shrink)

The cognitive science of belief is a burgeoning field, with insights ranging from detailing the fundamental structure of the mind, to explaining the spread of fake news. Here we highlight how new insights into belief acquisition, storage, and change can transform our understanding of psychiatric disorders. Although we focus on monothematic delusions, the conclusions apply more broadly. -/- .

Although formal thought disorder (FTD) has been for long a clinical label in the assessment of some psychiatric disorders, in particular of schizophrenia, it remains a source of controversy, mostly because it is hard to say what exactly the “formal” in FTD refers to. We see anomalous processing of terminological knowledge, a core construct of human knowledge in general, behind FTD symptoms and we approach this anomaly from a strictly formal perspective. More specifically, we present here a symbolic computational model (...) of storage in, and activation of, a human semantic network, or semantic memory, whose core element is logical form; this is normalized by description logic (DL), namely by CL, a DL-based language – Conception Language – designed to formalize conceptualization from the viewpoint of individual cognitive agency. In this model, disruptions in the rule-based implementation of the logical form account for the apparently semantic anomalies symptomatic of FTD, which are detected by means of a CL-based algorithmic assessment. (shrink)

In this article, we consider how certain types of contemporary biosocial psychiatric research conceptualise and explicate biology-social relations. We compare the historic biopsychosocial model to recent examples of social defeat research on schizophrenia and cultural neuroscience work on affective disorders. This comparison reveals how the contemporary turn towards the ‘biosocial’ within psychiatric research relies upon ideas of the psychological as an interface. This is problematic because psychological notions of ‘experience’ are used as the central mechanics of biosocial processes, but lack (...) any meaningful engagement with considerable debates within psychology and cognitive science about what the mind, and indeed the psychological, actually is, its relationship to social life, and how we should study it. The psychological interface is therefore vital to these biosocial hypotheses but is remarkably underdeveloped in comparison to its biological and sociological components. We argue that biosocial psychiatric research could gain a great deal from engaging with contemporary theorisations of experience and being more critical of vague appeals to psychological phenomena. (shrink)

The mid-century object relations approach saw the category of schizoids as crucial to its own formation. Rooted in a developmental phase where the perception of the mother as a whole and real person had not yet been secured, the schizoid constitution impeded relationships and forced schizoids to communicate through a compliant persona while the kernel self remained isolated. Fairbairn, Winnicott, and Guntrip thought that schizoid features underlay many other pathologies that earlier, Freudian psychoanalysis had misidentified. To correct this, a move (...) to the attachment-oriented theory was necessary, triggering the development of the object relations perspective as a distinct and independent approach. While playing this role in the development of object relations theory, the schizoid category also attracted a note of disapproval. Fairbairn, Winnicott, and Guntrip described schizoids as harmful to society through their everyday actions and through the ideas they propagated. This judgemental nuance highlights an aspect of the alliance between object relations theory and the contemporary welfare state ideology. Culminating in the Beveridge plan, that ideology framed citizenship as comprehensive engagement with society on multiple levels. Citizenship was not just a political activity but also a personally rewarding one, as it allowed expression to each person’s wishes in ways that benefited others. Inability to engage and be rewarded in this way marked obstinate classes and produced rigid and conservative ideologies that opposed the welfare state. Object relations theory described the schizoid condition along similar lines and castigated its consequences for similar reasons. (shrink)

In the field of clinical practice, there does not seem to be too much contention about what schizophrenia is, at least from a high level. After all, there are various diagnostic systems and guidelines, all of which point toward schizophrenia as a psychotic syndrome which likely forms a continuum with other psychotic disorders. It may sound obvious that, according to the current definitions, the major commonality between schizophrenia and all other psychoses is psychotic symptoms; more precisely, delusions and hallucinations. Any (...) description, or ‘phenomenology’ as most clinicians view it, can be found in these diagnostic manuals. However, is there anything at all that sets schizophrenia apart from the other... (shrink)

Die Fälle und die Erscheinungsformen von Ordnungswahn sind in Deutschland zahlreich und vielfältig infolge der Institutionalisierung des Wahns, weswegen Zwangsvorstellungen und Zwangshandlungen dieser Art nicht als therapiebedürftige Zwangsstörungen gelten, und jegliche Versuche, die Tendenz umzukehren, abgewehrt werden. Lernunfähigkeit und Unbeeinflußbarkeit schizophrener Personen und ihrer Gruppen machen jeden Vorsatz, etwas an bestehenden Verhältnissen zu ändern, zu beinah unmöglicher Aufgabe.

Heutige Sprache besteht aus versteinerten Formen, denen zu widersprechen für die meisten Menschen widersinnig erscheint. In diesem Empfinden des Widersinns im Widersprechen manifestiert sich psychischer Widerstand, der überwunden werden muß, indem er für alle, die davon betroffen sind, bewußt gemacht wird. Weil die Bewußtwerdung abgewehrter Inhalte ein Vorgang ist, der im Verlauf psychoanalytischer Behandlung oder Selbstbefragung bzw. Selbstinfragestellung zustande kommt, versuche ich die wesentlichen Ursachen für psychischen Widerstand aufzuzeigen.

This article describes a case of a teenager with early complex trauma due to chronic domestic violence. Cannabis use triggered auditory hallucinations, after which the teenager was diagnosed with an acute schizophrenia-like psychotic disorder. Antipsychotic medication did not fully resolve symptoms. Eventually the teenager chose to self-medicate with LSD in order to resolve a suicidal condition. The teenager carried out six unsupervised LSD sessions, followed by an extended period of almost daily use of inhaled low-dose DMT. Psychotic symptoms were mostly (...) resolved after approximately one year. Subsequent cannabis use caused a transient relapse. -/- While his psychosis may have been due to cannabis use in the presence of a genetic predisposition, LSD and DMT did not promote psychotic symptoms in this case, and resolved the suicidal condition in one session. Additional high-dose LSD sessions and low-dose DMT sessions appeared to resolve the symptoms related to the early complex trauma. Alternatively, if psychosis is understood as a massive defense system resulting from early complex trauma, and if his psychotic symptoms were partially due to such trauma, psychedelics appeared to transcend this defense system, providing access to traumatic memories in order to allow for an integrative treatment effect. -/- Information was acquired from medical record excerpts provided by the patient, a semi-structured retrospective video interview, and follow-up interviews a year later. The present case suggests a need for further studies on the relationship between psychedelics and psychotic disorders, the feasibility of supervised vs unsupervised settings for various situations, and alternative therapeutic models for utilizing the hyperaware-hypersensitive state induced by psychedelics. With regard to self-treatment, a harm reduction approach should be adopted. Low-risk psycholytic self-treatment protocols could be developed for future use in public health care systems. (shrink)

To explore the change of brain connectivity in schizophrenics, the resting-state EEG source functional connections of SCZ and healthy control were investigated in this paper. Different band single-layer networks, multilayer networks, and improved multilayer networks were constructed and their topological attributes were extracted. The topological attributes of SCZ and HC were automatically distinguished using ensemble learning methods called Ensemble Learning based on Trees and Soft voting method, and the effectiveness of different network construction methods was compared based on the classification (...) accuracy. The results showed that the classification accuracy was 89.38% for α band network, 82.5% for multilayer network, and 86.88% for improved multilayer network. Comparing patients with SCZ to those with Alzheimer’s disease, the classification accuracy of improved multilayer network was the highest, which was 88.12%. The power spectrum in the α band of SCZ was significantly lower than HC, whereas there was no significant difference between SCZ and AD. This indicated that the improved multilayer network can effectively distinguish SCZ and other groups not only when their power spectrum was significantly different. The results also suggested that the improved multilayer topological attributes were regarded as biological markers in the clinical diagnosis of patients with schizophrenia and even other mental disorders. (shrink)

Various psychopathologies of self-awareness, such as somatoparaphrenia and thought insertion in schizophrenia, might seem to threaten the viability of the higher-order thought (HOT) theory of consciousness since it requires a HOT about one’s own mental state to accompany every conscious state. The HOT theory of consciousness says that what makes a mental state a conscious mental state is that there is a HOT to the effect that “I am in mental state M” (Rosenthal 2005, Gennaro 2012). In a previous publication (...) (Gennaro 2015), I argued that a HOT theorist can adequately respond to this concern with respect to somatoparaphrenia. Somatoparaphrenia is a “depersonalization disorder” which is characterized by the sense of alienation from parts of one’s body. It is a bizarre type of body delusion where one denies ownership of a limb or an entire side of one’s body. My focus in the chapter, however, is on “inserted thoughts” which is a common symptom of schizophrenia, although it will also be useful to contrast it with somatoparaphrenia. Schizophrenia is a mental disorder which most commonly manifests itself through auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking. Thought insertion is the delusion that some thoughts are not “one’s own” in some sense or are somehow being inserted into one’s mind by someone else. Graham and Stephens (2000), for example, have suggested that thought insertion should be understood as alienated self-consciousness or meta-representation. I argue that HOT theory has nothing to fear from this phenomenon either and can consistently explain what happens in this admittedly unusual case. (shrink)

Schizophrenia is a serious mental disease whose pathogenesis has not been fully elucidated. Its clinical evaluation and diagnosis still highly depend on the clinical experience of doctors. It is of great scientific value and clinical significance to study the inducing factors and neuropathological mechanism of schizophrenia. Based on the four research problems of schizophrenia, this paper analyzes the data types that need to be stored in clinical trials and scientific research, including basic information, case report data, neuropsychological and cognitive function (...) evaluation, magnetic resonance data, electroencephalogram data, and intestinal flora data. Through the demand analysis of the system, including the data management part, data analysis part, the functional demand of the system management part, and the overall nonfunctional demand of the system, the overall architecture design, functional module division, and database table structure design of the system are completed. Adopting Browser/Server architecture and front-end and back-end separation mode and applying Java and Python programming language, based on spring framework and database, a multidimensional information management system for schizophrenia is designed and implemented, which includes four modules: data analysis, data management, system management, and security control. In addition, each functional module of the system is designed and implemented in detail, and the software operation flow of each module is illustrated with the sequence diagram. Finally, the multidimensional data of schizophrenia collected in our laboratory were used for system test to verify whether the system can meet the needs of clinical big data management of schizophrenia and the multidimensional information management system of schizophrenia can meet the needs of clinical big data management. The information management system helps schizophrenic researchers to carry out data management and data analysis. It also has advantages that are easy to use, safe, and efficient and has strong scalability in data management, data analysis, and scalability. It reflects the innovation of the system and provides a good platform for the management, research, and analysis of clinical big data of schizophrenia. (shrink)

This article adopts the hypothesis that language impairment in schizophrenia is more a sign of an interactional deficit than of a central disorder at the semantic level. Our aim is to better understand the rationality of the patient by significantly modifying how we conceptualize the mind, and to revisit the concept of belief. Our aim is to elucidate the degree to which this health dysfunction constitutes a mental disorder. We will do this by adopting an anthropological holism of the mental (...) such as the view Wittgenstein defended with his concept of language-games. This theory enables us to reconcile the two concepts of disordered language and ‘form of life’, with the particular form of life being schizophrenia. We center our argument on Robert Brandom’s expressivist, rationalist-pragmatist conception of mind and language. (shrink)

Diagnostic terms in psychiatry like ‘schizophrenia’ and ‘bipolar disorder’ are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of ‘schizophrenia.’ Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their actual usage (...) and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders. (shrink)

English abstract: On last day of the year 1999, Russia has entered another era of despotism, that of Vladimir Putin. During his reign, the Putin‘s clan has undermined and infiltrated the mass media, the parliament and the judicial system. Deliberate violation of basic citizen‘s rights, compulsory acquisition of property, government-funded racket, misuse of mass media to scarify and to disinform the peoples belong to the diabolic methods of self-constituted disposers. All this lawlessness has led to exorbitant corruption, mass poverty, economic (...) stagnation, and escalation of crimes. The actual manuscript investigates the roots of Putinism putting the person of Vladimir Putin in the focus of investigation. -/- Russian abstract: В 1999 году, в последний день столетия и тысячелетия, Россия вступила в новую эру деспотизма, эру Владимира Путина. В продолжение его правления, клан Путина коррумпировал и инфильтрировал средства массовой информации, парламент, правовую систему. Умышленное нарушение основных гражданских прав, конфискация собственности, государственный рэкет, злоупотребление средств массовой информации с целью запугивания и дезинформации населения стали дьявольскими методами самоназванных правителей. Всё это привело к безмерной продажности, массовой бедности, экономической стагнации и взрыву преступности. Данный манускрипт исследует корни Путинизма, помещая личность Владимира Путина в центр исследования. (shrink)

Брак может означать в одних случаях употребления брачные, т.е. супружеские узы, бракосочетание, в других случаях что-то совсем другое, а именно, изъян, изделие, не соответствующее техническим нормам, и поэтому негодное к употреблению. Производитель брака – бракодел, причина брака – недобросовестность, невнимательность, или дефекты орудия производства, в то время как частый результат брака в смысле бракосочетания и супружества – дети, которые тоже могут быть полноценными или неполноценными.

Winner of the 2020 Essay Competition of the International Social Ontology Society. -/- Ian Hacking uses the looping effect to describe how classificatory practices in the human sciences interact with the classified people. While arguably this interaction renders the affected human kinds unstable and hence different from natural kinds, realists argue that also some prototypical natural kinds are interactive and human kinds in general are stable enough to support explanations and predictions. I defend a more fine-grained realist interpretation of interactive (...) human kinds by arguing for an explanatory domain account of the looping effect. First, I argue that knowledge of the feedback mechanisms that mediate the looping effect can supplement, and help to identify, the applicability domain over which a kind and its property variations are stably explainable. Second, by applying this account to cross-cultural case studies of psychiatric disorders, I distinguish between congruent feedback mechanisms that explain matches between classifications and kinds, and incongruent feedback mecha- nisms that explain mismatches. For example, congruent mechanisms maintain Western auditory experiences in schizophrenia, whereas exporting diagnostic labels inflicts incongruence by influencing local experiences. Knowledge of the mechanisms can strengthen explanatory domains, and thereby facilitate classificatory adjustments and possible interventions on psychiatric disorders. (shrink)

The paper analyzes S.N. Spielrein’s scientific contribution to development K.G. Jung’s ideas. It starts with a list of areas pioneered by S.N. Spielrein’s and a review of literature which, as the author points out, is often biased, focusing not on the ideas of one of the first women in psychoanalysis, but on her personal life and individual characteristics. Further the paper analyzes several principal conceptions (with the exception of the original conception of destruction) where S.N. Spielrein’s contribution was essential. She (...) tried to give a more strict definition to C.G. Jung’s theory of the complex which played a key part in development of analytical psychology. S.N. Spielrein was the first to prove empirically in her dissertation the potential of the theory which contradicted classical psychoanalysis. S.N. Spielrein also played a part in development of C.G. Jung’s notions of philo- and ontogenesis of the mind in the process of the so called ‘complex intergrowth’ and gradually developing a common core in the form of I-consciousness. She also worked to define genesis of schizophrenia as a process of replacement of the personal content of the mind by collective contents. She contributed to development of the notion of the collective unconscious. The author analyzes her conception of ‘ancestral soul’ in the context of later achievements of analytical psychology, pointing out similarities in definitions. The author suggests a hypothesis on reasons why, after her separation from C.G. Jung, all mention of the collective unconscious disappeared from S.N. Spielrein’s publications. In conclusion, on the basis of characteristics of the female mind, identified by S.N. Shpilrein, the author hypothesizes on why actuality of her ideas has not been appreciated. Статья посвящена оценке научного вклада С.Н. Шпильрейн в развитие идей К.Г. Юнга. Основной текст предваряется указанием областей, в которых Шпильрейн оказалась первопроходцем, а также библиографическим обзором с выявлением слабых мест сложившейся традиции, сторонники которой предпочитают фокусироваться не на идеях одной из первых женщин-психоаналитиков, а на ее личной жизни и психологических особенностях. В основной части подробно рассматриваются несколько ключевых для аналитической психологии концепций (за исключением оригинальной концепции деструкции), вклад С.Н. Шпильрейн в развитие которых оказался наиболее существенным. Во-первых, анализируются ее усилия по уточнению сформулированной К.Г. Юнгом теории комплекса, сыгравшей ключевую роль в становлении аналитической психологии. С.Н. Шпильрейн стала первым исследователем, который в своей диссертации на конкретном эмпирическом материале доказал приемлемость этой теории, идущей вразрез с классическим психоанализом. Во-вторых, эксплицируется вклад С.Н. Шпильрейн в развитие представлений К.Г. Юнга о филогенезе и онтогенезе психики в результате так называемого комплексного срастания и постепенного обретения единого стержня в форме Я-сознания. В-третьих, отмечается роль Шпильрейн в уточнении генезиса шизофрении как процесса замещения личностных содержаний психики коллективными психическими содержаниями. В-четвертых, рассматривается вклад С.Н. Шпильрейн в развитие понятия коллективного бессознательного. В частности, анализируется ее учение о «душе рода» или «родовой душе» в контексте более поздних открытий аналитической психологии, указываются сходства формулировок. Кроме того, выдвигается гипотеза, почему после разрыва с К.Г. Юнгом в трудах С.Н. Шпильрейн полностью исчезают концепты, близкие понятию коллективного бессознательного. В заключение на основании выявленных С.Н. Шпильрейн особенностей женской психики строится предположение, почему ее идеи только сегодня стали по-настоящему актуальными. (shrink)

I argue that ordinary confabulation is a side-effect of an interpretive faculty that makes sense of the world by rationalising our experience within the context of a personal and cultural narrative. However, I argue that a hyperactivity of the same process manifests as schizotypy—latent schizophrenic tendencies—that can lead to extreme dissociation of interpretation from experience. I first give a phenomenological account of the process of interpretation, arguing that it is enacted through the creation of conceptual cognitive content from an originary (...) non-conceptual experience. I then ground this account in empirical evidence, showing how our direct perception is moulded and adapted as it is conceptualised to fit our individual and collective expectations. Finally, I argue that hyperactive over-interpretation results in schizotypic dissociation, thus suggesting that schizophrenia should be understood as a disorder of interpretation, the extreme end of a spectrum that includes ordinary confabulation. (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...

Much of the characteristic symptomatology of schizophrenia can be understood as resulting from a pervasive sense of disembodiment. The body is experienced as an external machine that needs to be controlled with explicit intentional commands, which in turn leads to severe difficulties in interacting with the world in a fluid and intuitive manner. In consequence, there is a characteristic dissociality: Others become problems to be solved by intellectual effort and no longer present opportunities for spontaneous interpersonal alignment. This dissociality goes (...) hand in hand with a progressive loss of the socially extended mind, which normally affords opportunities for co-regulation of cognitive and affective processes. However, at times people with schizophrenia report that they are confronted by the opposite of this dissociality, namely an unusual fluidity of the self-other boundary as expressed in experiences of ambiguous body boundaries, intrusions, and even merging with others. Here the person has not lost access to the socially extended mind but has instead become lost in it, possibly due to a weakened sense of self. We argue that this neglected aspect of schizophrenic social dysfunction can be usefully approached via the concept of genuine intersubjectivity: We normally participate in a shared experience with another person by implicitly co-regulating how our interaction unfolds. This co-regulation integrates our respective experience’s dynamical bases into one interpersonal process and gives the interaction an ambiguous second-person character. The upshot is that reports of abnormal self-other fluidity are not indicative of hallucinations without any basis in reality, but of a heightened sensitivity and vulnerability to processes of interpersonal alignment and mutual incorporation that form the normal basis of social life. We conclude by discussing implications of this view for both the science of consciousness as well as approaches to intervention and therapy. (shrink)

In his commentary, Louis Sass points out some aspects of excentricity that are important to keep in mind when applying the notion to schizophrenia.First, it is true that the failure of the excentric position may not be equated with the naïve egocentricity of Piaget's young child—it is not a "regression" to an earlier developmental stage. On the contrary, paranoid delusion is only possible because the patients had already acquired the excentric position before, for this is what leads them to see (...) themselves "in others' eyes"—namely being observed, spied at, persecuted by them. The problem is rather that their perspective-taking is unbound, forces itself on them, and may not... (shrink)

Today the concept of 'schizophrenia' is often presented in psychiatric texts as a construct, a construct bringing together a diverse and, allegedly, independently assailable range of signs and symptoms. According to such a diagnostic scheme two patients may both be allowed to count as suffering from schizophrenia despite sharing hardly a single symptom. The validity of the concept has accordingly been contested by psychologists for its apparent lack of unity. In the absence of clear independent evidence of a unitary physiological (...) disease process underlying such diverse phenomena, a natural enough suggestion has been to... (shrink)

In her commentary, Dibitonto helpfully compares my understanding of schizophrenic ego disturbance with that of Blankenburg. His patient Anne described her true schizophrenic difficulty as obtaining in some sense 'before' those experiential disturbances she can articulate. Ordinary conversational modes misleadingly invite her and us to attempt describing her difficulties in terms which presuppose the intactness of, rather than capture the underlying disturbance to, her self-hood. They fail to locate the disturbance deep enough, fail to grasp how it arises 'before' what (...) is readily articulable in the psyche. I believe this is the same 'before' which prompts my own articulation of schizophrenic ego... (shrink)

Despite increasing interest in the work of Tetsuro Watsuji, his discussion of intentionality remains underexplored. I here develop an interpretation and application of his view. First, I unpack Watsuji’s arguments for the inherently social character of intentionality, consider how they connect with his more general discussion of embodiment and betweenness, and then situate his view alongside phenomenologists like Husserl, Heidegger, and Merleau-Ponty. Next, I argue that Watsuji’s characterization of the social character of intentionality is relevant to current discussions in phenomenological (...) psychopathology. I consider how it can help illuminate the character and structure of some anomalous experiences in schizophrenia. I argue further that this application can enrich existing attempts to connect Watsuji and psychopathology, such as those found in the work of the psychiatrist Bin Kimura. (shrink)

Orthodox neurocognitive accounts of the bodily sense of agency suggest that the experience of agency arises when action-effects are anticipated accurately. In this paper, I argue that while successful anticipation is crucial for the sense of agency, the role of unsuccessful prediction has been neglected, and that inefficacy and uncertainty are no less central to the sense of agency. I will argue that this is reflected in the phenomenology of agency, which can be characterized both as the experience of efficacy (...) and effort. Specifically, the “sense of efficacy” refers to the perceptual experience of an action unfolding as anticipated. The “sense of effort”, in contrast, arises when an action has an uncertain trajectory, feels difficult, and demands the exertion of control. In this case, actions do not unfold as anticipated and require continuing adaptation if they are to be efficacious. I propose that, taken individually, the experience of efficacy and effort are insufficient for the sense of agency and that these experiences can even disrupt the sense of agency when they occur in isolation from each other. I further argue that a fully-fledged sense of agency depends on the temporally extensive process of prediction error-cancelation. This way, a comparator account can accommodate both the role of accurate prediction and prediction error and thus efficacy and effort. (shrink)

The Research Domani Criteria framework (RdoC) encourages research on specific impairments present across traditional nosological categories and suggests a list of biological and behavioral measures for assessing them. After a description of RdoC, in this article we focus on impairments of the ability of understanding others, specifically in Theory of Mind and empathy. We illustrate recent evidence on brain anomalies correlating with these deficits in Schizophrenia, Addiction Disorders and Mood Disorders populations. In the last section, we zoom out and consider (...) this kind of research vis-à-vis the objection of being reductionistic that is, in favoring mechanistic accounts of mental disorders. We argue that metaphysical reductionism and explanatory reductionism are not conceptually entailed by the RdoC framework. (shrink)

Donald Capps (2009: 145) suggested the hypothesis that “the Nash equilibrium is descriptive of the normal brain, whereas the game theory formulated by John van Neumann, which Nash’s theory challenges, is descriptive of the schizophrenic brain”. The paper offers arguments in its favor. They are from psychiatry, game theory, set theory, philosophy and theology. The Nash equilibrium corresponds to wholeness, stable emergent properties as well as to representing actual infinity on a material, limited and finite organ as a human brain.

Several theories propose that one of the core functions of inner speech (IS) is to support subjects in the completion of cognitively effortful tasks, especially those involving executive functions (EF). In this paper we focus on two populations who notoriously encounter difficulties in performing EF tasks, namely, people diagnosed with schizophrenia who experience auditory verbal hallucinations (Sz-AVH) and people within the Autism Spectrum Conditions (ASC). We focus on these two populations because they represent two different ways in which IS can (...) fail to help in EF tasks, which can be illustrative for other mental conditions. First, we review the main components of EF (Section 1). Then we explain the functions that IS is taken to perform in the domain of EF (Section 2) and review the evidence concerning problems about EF in the two populations of our study: Sz-AVH (Section 3) and ASC (Section 4). After this we further detail our account about what a properly functioning IS can do for both populations and how different IS profiles may impact EF performance: in the case of Sz-AVH, the uncontrolled and intrusive character of IS negatively affects EF performance, whereas in ASC, EF is not sufficiently supported by IS, given the tendency in this population to present a diminished use of IS (Section 5). We finally briefly discuss Attention Deficit/Hyperactivity Disorder (ADHD) and Developmental Language Disorders (DLD). (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)

Появление человека, говорящего о себе Ἐγώ εἰμι, люди воспринимают в той же логике абсурда, к которой они привыкли. То, что кто-то может не играть и не носить маску, а реально быть, жить настоящей, а не выдуманной жизнью, для них немыслимо, невозможно, невыносимо и недопустимо. Но такой человек был, есть, и будет, и именно он преображает всё остальное человечество своим Ἐγώ εἰμι.

Die Wiederaufnahme unterbrochener Handlungen nach der Aussetzung der Maßnahmen zur Eindämmung von CoVid19 veranschaulicht Unveränderlichkeit und Unvergänglichkeit regressives Zustandes, in dem sich weite Teile der Bevölkerung befinden. Nach kurzer Unterbrechung kommt alles in gewöhnten Kreis alltäglicher Routine und Gedankenlosigkeit, mit denen solche Aufgaben erledigt werden. Nichts, aber gar nichts änderte sich nach dem Unglück, das eigentlich, wie in meisten solchen Fällen, die Gelegenheit bietet, über sich selbst und die Welt nachzudenken.

In "Delusion, Reality, and Intersubjectivity," Thomas Fuchs offers a superb presentation of an enactive/phenomenological approach to schizophrenic delusions—an approach that is clearly superior to the poor-reality-testing formula that has dominated thinking about delusion in psychiatry, psychoanalysis, and cognitive-behavioral theory. As he convincingly argues, two key tendencies go a long way toward accounting for the distinctive features of delusion in schizophrenia: 1) withdrawal from practical, sensori-motoric interaction with the physical environment; and 2) failure to experience reality in intersubjective terms—as a realm (...) of "participatory... (shrink)

This paper challenges the common assumption that some phenotypic traits are quantitative while others are qualitative. The distinction between these two kinds of traits is widely influential in biological and biomedical research as well as in scientific education and communication. This is probably due to both historical and epistemological reasons. However, the quantitative/qualitative distinction involves a variety of simplifications on the genetic causes of phenotypic variability and on the development of complex traits. Here, I examine three cases from the life (...) sciences that show inconsistencies in the distinction: Mendelian traits, Mendelian diseases, and polygenic mental disorders. I show that these traits can be framed both quantitatively and qualitatively depending, for instance, on the methods through which they are investigated and on specific epistemic purposes. This suggests that the received view of quantitative and qualitative traits has a limited heuristic power—limited to some local contexts or to the specific methodologies adopted. Throughout the paper, I provide directions for framing phenotypes beyond the quantitative/qualitative distinction. I conclude by pointing at the necessity of developing a principled characterisation of what phenotypic traits, in general, are. (shrink)

Although not identical, this article suggests that complex posttraumatic stress disorder, depersonalization and schizophrenia share at least one feature: in all these cases, the body becomes a defective tool, an IT. In turn, those suffering from them can no longer be-in-the-world through the living body but rather experience their body as an object; they manage their lives on the level of body image.The next section outlines some cognitive and phenomenological concepts such as body schema, body image, body-as-subject and body-as-object. Thereafter, (...) the article explores the phenomenology of C-PTSD, depersonalization, and schizophrenia, finally suggesting that in each of these cases the body... (shrink)

In this paper I aim to re-think the question of the world of persons with schizophrenia from the perspective of the German phenomenologist Max Scheler and that of the Japanese psychiatrist Bin Kimura. So far, no comparison between these two authors has been made, even though there are several convergences and evidence of Scheler’s indirect influence on Bin Kimura through Viktor von Weizsäcker. In recent years, Dan Zahavi, Louis Sass, and Josef Parnas have interpreted the modus vivendi of schizophrenic patients (...) in relation to a disturbance on the level of the “minimal self”. Subsequently, the discussion has highlighted the importance of disorders on the level of intercorporeality and intersubjectivity (Thomas Fuchs) and on the level of “existential feelings” (Matthew Ratcliffe). This paper argues that Max Scheler and Bin Kimura allow us to focus on an aspect which has been neglected so far: that of a “relational self” that relates to the very foundation of intersubjectivity and intercorporeality and that can thus be reborn in the encounter with the other and may position itself differently in the world. In Scheler’s perspective, the world of persons with schizophrenia is the result of an axiological disorder (valueception) that impairs contact with the primordial life impulse (Lebensdrang). As a consequence, they are incapable of attuning emotionally and socially with others: this prevents the singularity from being reborn in the encounter with the other and forces them to position themselves in their own solipsistic universe. Moving in a similar direction, Bin Kimura interprets the world of persons with schizophrenia as the result of a disorder of aida (one of the central concepts of Japanese culture that indicates the space of being in between). The disorder of aida compromises the basic relationship (Grundverhältnis in the sense of Viktor von Weizsäcker) and hinders what Bin Kimura calls festum, i.e. the birth of subjectivity, so that it is experienced by persons with schizophrenia only as ante festum. Starting from these two perspectives, I argue the existence of an axiological and anthropogenetic dimension of psychopathology. I begin with a discussion of Zahavi’s concept of minimal self and the thesis that reveals the disorders on this level of subjectivity as the origin of the world of persons with schizophrenia. I, then, analyze Max Scheler’s position and its historic importance for the emergence of phenomenological psychopathology. Thereafter, I introduce the concepts of “disorder of aida” (Bin Kimura) and “disorder of ordo amoris” (Max Scheler). Finally, I develop the concept of a “psychopathology of ordo amoris” by also comparing it with Ratcliffe’s thesis of “existential feelings”. (shrink)

The project of therapeutic approaches sensible to the very subjective experience of patients suffering from schizophrenia, especially those treatments most used in current practice, as pharmacological, is and must always be and unambiguously welcomed.Phenomenology is a rich and fertile tradition, born in modern academic philosophy, that along the development of psychopathology in the twentieth century inspired sophisticated theories and new conceptual tools for clinical descriptions and understanding of mental patients and disorders such as schizophrenia...

In the introduction to a recent anthology of contemporary issues in philosophy of psychiatry, editors Jeffrey Poland and Şerife Tekin declare this to be a moment of crisis within the field. They suggest that the state of psychiatry today reflects Thomas Kuhn's conception of a period of extraordinary science, which occurs when anomalies begin to build up, confidence in the dominant paradigm is shook, competing theories arise, and philosophical questions come to the fore. Although perhaps not all would agree that (...) the field is in crisis, there is certainly an abundance of pessimism. Within the realm of research, a mood of explanatory pessimism has been growing, characterized by a... (shrink)

This article examines the role of time as a methodological tool and pathological focus of clinical psychiatry and psychology in the first half of the 20th century. Contextualizing ‘psychopathologies of time’ developed by practitioners in Europe and North America with reference to the temporal theories implicit in Freudian psychoanalysis and Henri Bergson’s philosophy of durée, it illuminates how depression, schizophrenia, and other mental disorders such as obsessive-compulsive behaviours and aphasia were understood to be symptomatic of an altered or disturbed ‘time-sense’. (...) Drawing upon a model of temporal synthesis whereby in healthy individuals, a subjective temporal sense was perceived and understood in relation to objective time frameworks, clinicians argued that mentally ill patients were unable to synthesize Ichzeit and Weltzeit, using variations in this disturbance to define specific pathological conditions. (shrink)