This chapter offers an overview of the phenomenological approach to delusions, emphasizing what Karl Jaspers called the "true delusions" of schizophrenia. Phenomenological psychopathology focuses on the experience of delusions and the delusional world. Several features of this approach are surveyed, including emphasis on formal qualities of subjective life and questioning of standard assumptions about delusions as erroneous belief. The altered modalities of world-oriented and self-oriented experience that precede and ground delusions in schizophrenia, especially the experiences of revelation that Klaus Conrad (...) termed the outer and inner apophany, are then discussed. The chapter first considers the famous "delusional mood", then the role of ipseity-disturbance. In both cases it is explained how delusions can develop out of these distinctive alterations of perception and feeling. The classic question of the understandability or comprehensibility of schizophrenic delusion, together with the related issues of wish-fulfillment and rationalizing motives are then considered. The chapter addresses the crucial but neglected issue of the felt reality-status of delusions or the delusional world, discussing derealization, "double bookkeeping", and "double exposure". The chapter concludes by discussing delusions typically found in paranoid and affective psychoses, and monothematic delusions found in certain organic conditions. (shrink)

Although excess blood collection has characterized U.S. national disasters, most dramatically in the case of September 11, periodic shortages of blood have recurred for decades. In response, I propose a new model of medical philanthropy, one that specifically uses charitable contributions to health care as blood donation incentives. I explain how the surge in blood donations following 9/11 was both transient and disaster-specific, failing to foster a greater continuing commitment to donate blood. This underscores the importance of considering blood donation (...) incentives. I defend charitable incentives as an alternative to financial incentives, which I contend would further extend neoliberal market values into health care. I explain my model's potential appeal to private foundations or public–private partnerships as a means for expanding both the pool of blood donors and the prosocial benefit of each act of blood donation. Finally I link my analysis to the empirical literature on blood donation incentives. (shrink)

mit Beitr. v. Günter C. Behrmann. hrsg. v. Günter Saße. ; Volltext // Exemplar mit der Signatur: München, Bayerische Staatsbibliothek -- Z 65.262-1447.

This article presents an introductory overview of the interpretations of schizophrenia offered by three phenomenological psychiatrists: Eugene Minkowski (1885-1972), Wolfgang Blankenburg (b. 1928), and Kimura Bin (b. 1931). Minkowski views schizophrenia as characterized by a diminished sense of dynamic and vital connection to the world ("loss of vital contact"), often accompanied by a hypertrophy of intellectual and static tendencies ("morbid rationalism," "morbid geometrism"). Blankenburg emphasizes the patient's loss of the normal sense of obviousness or "natural self-evidence"—a loss of the usual (...) common-sense background that enables normal persons to cope easily with the social and practical world. Kimura focuses on certain distortions of self-experience: a distinctive splitting of the subjective self, alienated awareness of one's own ongoing consciousness, and profound uncertainty about the "I-ness" of the self. In addition to a summary, this article offers a comparison and critique of these three approaches. The three approaches are also considered in light of a more recent, phenomenological formulation of schizophrenia as a disorder of self-experience (an ipseity disturbance) involving hyperreflexivity and diminished self-affection (i.e., heightened awareness of aspects of experience that would normally remain tacit or presupposed and decline in the feeling of existing as a subject of awareness). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 71-80 [Access article in PDF] Some Reflections on the (Analytic) Philosophical Approach to Delusion Louis A. Sass There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." —Hamlet, Act I, Scene 5 The peculiar, often problematic phenome na of psychopathology have been attract ing the attention of analytic philosophers in recent years. The topic of delusion has (...) been a particular draw, with a number of analytic philosophers attempting to use their conceptual tools, usually combined with ideas from cognitive neuroscience, to criticize the traditional understanding and to clarify the nature of this central psychiatric topic. It is useful to have this kind of interdisciplinary dialogue. Indeed, there is good reason to hope that concepts honed in the philosophy of mind and other philosophical subfields will help to sort out our understanding of a phenomenon (or set of phenomena) for which contemporary psychiatric definitions and conceptualizations are clearly inadequate and, in some respects, downright misleading (see Parnas and Sass 2001; Spitzer 1990).1Here, however, I would like to call attention to some weaknesses that, it seems to me, are rather common (I do not say universal) in many analytic philosophical approaches to psychopathology. In my opinion, there is a tendency to formulate issues and arguments in overly polarized, even dichotomous terms, and then to rely too uncritically on these essentialistic formulations in exploring the domain of inquiry. Although this polarizing tendency sometimes has the salutary effect of clarifying conceptual domains, it can, when taken too far, actually hamper our understanding of phenomena that are often fraught with ambiguities and complexities that defy many standard conceptualizations.The relationship between philosophy and psychopathology is obviously a two-way street—we are familiar, for example, with disorders that challenge deep philosophical assumptions about self and mind (e.g., blindsight, split-brain phenomena, perhaps also Dissociative Identity Disorder, and the first rank symptoms of schizophrenia). I am suggesting that, in their work on delusions, philosophers may need to put more emphasis on moving from the natural phenomena [End Page 71] of psychopathology and to the domain of philosophical analysis.I believe that a greater sensitivity to the modes of knowing associated with the phenomenological tradition, and to the forms of conceptual self-critique fostered by Ludwig Wittgenstein, are crucial ingredients for any adequate approach to delusion as well as many other topics in psychopathology. In my opinion, the work of many analytic philosophers interested in psychopathology would be enriched if they spent more time trying to discover and imagine what it might be like to experience certain kinds of abnormal psychiatric conditions, and also speculating about what implications such experiential modalities might have for action and verbal expression. I believe they would also be wise to spend more time questioning, and attempting to transcend, the philosophically derived conceptual distinctions and dichotomies that appear to organize their conceptual universes. Phenomenological imagination and Wittgensteinian critique can show how to move outside the conceptual capsule and into the rich and strange realms of actual experience, both normal and abnormal.So far I have offered only slogans. Let me use the articles by Tim Bayne and Elisabeth Pacherie (2004) and Robert Klee (2004) to flesh out the criticisms I have offered. There is much that is intelligent and much that is worthwhile in both their articles. (For example, I was largely convinced by the criticisms of John Campbell and of Donald Davidson that are central to the articles by Bayne and Pacherie and by Klee, respectively.) Here, however, I will focus only on issues that illustrate the above-mentioned tendencies—tendencies that, in my view, tend to infect even the best writings on the (analytic) philosophy of psychiatry. I will also make some remarks about the works of Campbell and Davidson, the two philosophers criticized in the articles by Bayne and Pacherie and by Klee. Because the article by Eugenie Georgaca (2004) is in a different tradition, I will say only a few words about it at the end. Bayne and Pacherie on the Preservation-Of-meaning... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 125-132 [Access article in PDF] Incomprehensibility and Understanding:On the Interpretation of Severe Mental Illness Louis A. Sass Keywords hermeneutics, psychopathology, paradox, Wittgenstein, solipsism, delusion, principle of charity, phenomenological psychopathology. I would like to begin by thanking Rupert Read for the care he has put into reading my work, and into thinking through its implications in the context of the "new-Wittgensteinian" interpretation of the (...) thought of Ludwig Wittgenstein. This interpretation derives from an influential reading of this philosopher's early book, the Tractatus Logico-Philosophicus (1961), that is not explicitly discussed in Read's article, yet that lies behind much of his argument. Read does allude to this reading of the Tractatus when he refers to the concept of "logically alien thought" (see Conant [1992]), and by citing, in his endnotes, the Diamond, Conant, and Cerbone articles that appear in Crary and Read's edited collection, The New Wittgenstein (2000). In an earlier paper that also addresses my work, "On approaching schizophrenia through Wittgenstein," Read (2001) explicitly discusses the relevance of the new-Wittgensteinian interpretation of the Tractatus.According to this new-Wittgensteinian interpretation of the Tractatus, Wittgenstein took absolutely seriously his own realization (explicitly stated at the end of the Tractatus) that his book was internally self-contradictory, and he therefore realized that all or nearly all the sentences of the Tractatus must be totally devoid of any meaning or semantic reference. According to this austere view, the vast bulk of the Tractatus only pretends to be making meaningful statements about the nature of logic and semantics; its real purpose is to give the reader the illusion of meaning, and this it does in order to lead the reader to the eventual realization that there can in fact be no meaningful statements or thoughts at the level of self-referential abstraction at which the Tractatus pretends to be operating. Further, when Wittgenstein (1961) writes (in the famous last line of the book), "Whereof one cannot speak, thereof one must be silent" (p. 189), this statement should, supposedly, not be taken as any kind of mystical pointing toward some ineffable realm or truth, but, rather, as an austere recognition that there just are no ineffable truths—that, so to speak, there just is no mystical there there. [End Page 125]Rupert Read sees an analogy between, on the one hand, the (supposedly mistaken) readers of Wittgenstein's Tractatus who think that Wittgenstein is exploiting self-contradiction to allude to some higher, ineffable truth (i.e., something that can be pointed at even if it cannot be said), and, on the other hand, my own elucidation of Schreber's contradictions (see especially Chapter 2 of Paradoxes of Delusion [1994]) to argue that Schreber can be said to be having particular kinds of experiences, which I refer to as solipsistic or quasi-solipsistic in nature. Just as Wittgenstein's self-contradictions can (supposedly) point nowhere other than to their own failure to mean, so Schreber's self-contradictory and other nonstandard statements cannot (according to Read) be used to illuminate in any meaningful way the form of experience that supposedly lies behind them—as I, for example, have tried to do by offering a phenomenological account of Schreber and schizophrenia. Patients like Schreber and Renée cannot really be understood, just as we cannot really understand logically alien thought—which, in fact, is not really thought at all; in both cases, there is only the illusion of meaning, only the mirage of an alternative mode of thinking or of living. This, at least, is Read's new-Wittgensteinian claim.Few readers of Philosophy, Psychiatry, & Psychology will, I suspect, be familiar with these discussions centering on Wittgenstein's Tractatus, which were introduced largely by the philosophers Cora Diamond and James Conant (see Crary and Read [2000]). (I myself have found their writings fascinating and inspiring in many ways, despite my ultimate disagreement on fundamental issues.) 1 Most readers of Philosophy, Psychiatry, & Psychology will have no way of assessing the validity of this austere reading of the Tractatus... (shrink)

This paper defends an ontology of weak entity realism for homeostatic property cluster (HPC) theories of natural kinds, adapted from Bird’s (Synthese 195(4):1397–1426, 2018) taxonomy of such theories. Weak entity realism about HPC kinds accepts the existence of natural kinds. Weak entity realism denies two theses: that (1) HPC kinds have mind-independent essences, and that (2) HPC kinds reduce to entities, such as complex universals, posited only by metaphysical theories. Strong entity realism accepts (1) and (2), whereas moderate entity realism (...) accepts only (1). Given its commitment to (2), strong entity realism is more theoretically complex than weak entity realism, with little explanatory payoff. Given their commitment to (1), moderate and strong entity realisms cannot explain how the identity conditions of HPC kinds are to be straightforwardly knowable. I argue that weak entity realism avoids such epistemic difficulties. I further rebut two plausible criticisms of weak entity realism, namely that weak entity realism cannot account for quantification over kinds, and that weak entity realism cannot provide identity conditions for HPC kinds which are both scientifically useful and objective. Given the theoretical costs of strong and moderate entity realism, and weak entity realism’s adequate response to its most plausible challenges, weak entity realism about HPCs is to be preferred, especially for biological and chemical kinds. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)

In the United States, at least 6% of all hospital beds are in the intensive care unit or coronary care unit. The cost of treating a patient in an intensive care unit averages from $2,000 to $3,500 per day. At least 10–40% of intensive care patients will not survive to hospital discharge. Today, every major category of disease may be found in the modern ICU; common diagnoses are septicemia, postsurgical complications, cerebrovascular accidents, gastrointestinal bleeding, neoplasia, and respiratory failure. ICUs employ (...) some of the most sophisticated medical technology, routinely monitoring the cardiopulmonary performance of patients and often providing assisted ventilation. ICUs are high intensity in terms of their staffing, involving 24-hour physician supervision and nurse:patient ratios from 1:3 to 1:1. (shrink)

We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the pre-psychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global (...) reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. (shrink)

What does it mean for ethics to say, as Wittgenstein did, that philosophy “leaves everything as it is”? -/- Though clearly absorbed with ethical questions throughout his life and work, Wittgenstein's remarks about the subject do not easily lend themselves to summation or theorizing. Although many moral philosophers cite the influence or inspiration of Wittgenstein, there is little agreement about precisely what it means to do ethics in the light of Wittgenstein. -/- Ethics after Wittgenstein brings together an international cohort (...) of leading scholars in the field to address this problem. The chapters advance a conception of philosophical ethics characterized by an attention to detail, meaning and importance which itself makes ethical demands on its practitioners. Working in conversation with literature and film, engaging deeply with anthropology and critical theory, and addressing contemporary problems from racialized sexual violence against women to the Islamic State, these contributors reclaim Wittgenstein's legacy as an indispensable resource for contemporary ethics. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs,1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process.2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV as well (...) as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the difficulty of even engaging with community members in oppressive settings, where authorities severely restrict civil liberties of PWID so that even discussing issues related to drug use and enforcement may place individuals at risk. To overcome such limitations, he appropriately suggests interviewing confidentially those who have previously been detained in closed settings as part of the community engagement process. Similarly, Wolfe observes that critical issues can be overlooked with a narrow focus on study procedures if contextual factors before, during or after a study are ignored. For example, he cites the risk of overdose for study participants who have been abstinent during a study and subsequently resume injecting when the study concludes. These kinds of risks may not be obvious …. (shrink)

In crafting our paper on addressing the ethical challenges in HIV prevention research with people who inject drugs, 1 we had hoped to stimulate further discussion and deliberation about the topic. We are pleased that three commentaries on our paper have begun this process. 2 3 4 The commentaries rightly bring up important issues relating to community engagement and problems in translating research into practice in the fraught environments in which PWID face multiple risks. These risks include acquisition of HIV (...) as well as criminalisation, stigma and lack of access to needed healthcare, prevention and social services. We take this opportunity to respond to the excellent points raised by the commentators. All of the commentaries support our emphasis on robust community engagement with PWID and other stakeholders in designing and conducting HIV prevention research, but urge us to go farther. Wolfe highlights the... (shrink)

This article examines the structure of self-consciousness in people with schizophrenia. The findings indicate that our self-experience is not neutral with respect to the metaphysical status of the self and that it is important to attend carefully to the experience of the subject in order to understand schizophrenia. The results also suggest that the variable disruptions in the sense of self-presence, first-person perspective, and the phenomenality of experience in schizophrenics directly affect the minimal self and it may also have implications (...) for the narrative self. (shrink)

A well-known difficulty of the interdisciplinary dialogue beyond the limits of particular disciplines is the lack of common ground regarding their metaphysical and methodological assumptions and commitments. This is particularly evident for the precarious relationship between science and religion. In a 2016 conference entitled “The Many Faces of Panentheism” held in Zurich, and now in this introduction as well as this section, we try to counteract this situation by choosing a focus theme located at the interface between nature and the (...) divine. Thus, key perspectives, arguments, and implications of panentheism are introduced not only from one selected point of view but in relation to others. This allows us to explore territory beyond the boundaries of disciplinary backgrounds and to address intellectual and practical consequences for current debates. (shrink)

In this response to Wiggins and Schwartz, Ratcliffe, and Stanghellini, we first wish to express our gratitude to Philosophy, Psychiatry, and Psychology for providing us the space to clarify our views and to overcome certain misunderstandings. Ratcliffe notes that our critique is "harsh," whereas Wiggins and Schwartz lament the fact that the debate "has taken the form of sometimes acid formulations and rejoinders . . . that lack the tone of mutual appreciation" (2011, 31). We deplore the fact that this (...) exchange was at all necessary, and we share Wiggins and Schwartz's concerns. However, we need to recall here and emphasize that our article originated as a response. It originated as a response to an article that was .. (shrink)

The life of Saint Teresa of Jesus, the most famous mystic of sixteenth-century Spain, was characterized by recurrent visions and states of ecstasy. In this paper, we examine social components related to Teresa’s personal crises and the historical conditions of her times, factors that must be taken into account to understand these unusual forms of experience and behavior. Many of these factors (e.g., increasing individualism and reflexivity) are precursors of the condition of modern times. Indeed, certain parallels can be observed (...) between Saint Teresa and certain present-day psychopathological disorders. The analogy should not, however, be carried too far. Religion played a particularly crucial role in Teresa’s cultural context; as a result, it would be misleading to view her mystical experiences as resulting from a mental disorder. (shrink)

Künstlerische Naturnachahmung zielt auf einen gesteigerten Realitätsgrad der Bildwerke. Die Beiträge des Bandes gehen der Frage nach, welche Relevanz Praktiken bildnerischer Beschreibung und Spielarten von Illusionismus haben und inwieweit sich aus der scheinbaren Zurücknahme der künstlerischen Intervention Momente von Objektivität und Ansprüche auf Wahrheit ableiten. Dabei werden die divergierenden Bedeutungen des Naturlismus-Begriffs deutlich.

New dimensions in different ethical scenarios following genetic information require new medical-ethical Action Guides for physician-patient interaction. This paper discusses the ambiguity in moral choice between a “right not to know” and “a duty to know”, regarding parental decisionmaking pro or contra selective abortion following prenatal screening for autosomal dominant polycystic kidney disease (Potter III) and related public policy issues.

In the standard formulation of game theory, agents use mixed strategies in the form of objective and probabilistically precise devices to conceal their actions. We introduce the larger set of probabilistically imprecise devices and study the consequences for the basic results on normal form games. While Nash equilibria remain equilibria in the extended game, there arise new Ellsberg equilibria with distinct outcomes, as we illustrate by negotiation games with three players. We characterize Ellsberg equilibria in two-person conflict and coordination games. (...) These equilibria turn out to be related to experimental deviations from Nash equilibrium play. (shrink)

Madness and Modernism provides a phenomenological study of schizophrenic disorders, criticizing some standard conceptions of these disorders. Sass argues that many aspects of this group of disorders can actually involve more sophisticated (albeit dysfunctional) forms of mind and experience.

This current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience was used to interview ten participants with schizophrenia spectrum disorders and a comparison group of three participants with major depressive disorder. Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less (...) stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia. (shrink)

This paper outlines several of the challenges that are inherent in any attempt to communicate subjective experience to others, particularly in the context of a clinical interview. It presents the phenomenological interview as a way of effectively responding to these challenges, which may be especially important when attempting to understand the profound experiential transformations that take place in schizophrenia. Features of language experience in schizophrenia—including changes in interpersonal orientation, a sense of the arbitrariness of language, and a desire for faithful (...) communication of experience —are described, together with discussion of their relevance for the interview context. Furthermore, the interview presents a unique context in which both intersubjective and interpersonal aspects of experience will be described as well as evoked. It is proposed that phenomenological interviewers should not only be familiar with these and other experiences that can occur in schizophrenia, but also capable of applying the techniques of phenomenological and hermeneutic methods in order to understand the descriptions of interviewees with sensitivity and accuracy. (shrink)

Zusammenfassung Dies ist eine Antwort auf George Pattisons magistrale Triologie über eine „Philosophy of Christian Life“ – mit Schwerpunkt auf dem zweiten Teil: „A Rhetorics of the Words“. Der Beitrag bietet eine Analyse des zentralen Begriffes, nämlich des „Rufs“ oder der „Berufung“. Dies führt zu drei grundlegenden Fragen nach dem fehlenden Gemeinschaftscharakter der Berufung in Pattisons Darstellung; seiner einseitigen Neigung zum Pessimismus in seiner Kulturkritik; und, der nur marginalen Rolle, die andere Artikulationen als der Ruf innerhalb eines „frommen Lebens“ und (...) seiner ambivalenten Autorität spielen. (shrink)

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)