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)

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)

During the last years, there has been an important discussion on the concept of mental disorder. Several accounts of such a concept have been offered by theorists, although neither of these accounts seems to have successfully answered both the question of what it means for a certain mental condition to be a disorder and the question of what it means for a certain disorder to be mental. In this paper, I propose an account of the concept of mental disorder that, (...) if I am right, provides satisfactory answers to both of these questions. Furthermore, this account (unlike other accounts presented in the literature on the subject) meets the requirements for achieving a crucial goal underlying the project of sorting out the concept of mental disorder, namely the goal of allowing the existence of a dialogue between mental health professionals of different theoretical orientations. To achieve this goal, the account herein proposed is not based in any particular theoretical framework, but in both ordinary and technical theory-neutral concepts. In the last part of the paper, I argue that it follows from most accounts of the concept of mental disorder that the disciplines concerned with explaining some mental disorders are not branches of medicine, and that the treatment of some mental disorders is not a matter of medical intervention. (shrink)

Is insanity a myth? Does it exist merely to keep psychiatrists in business? In Insanity: The Idea and Its Consequences, Dr. Szasz challenges the way both science and society define insanity; in the process, he helps us better understand this often misunderstood condition. Dr. Szasz presents a carefully crafted account of the insanity concept and shows how it relates to and differs from three closely allied ideas—bodily illness, social deviance, and the sick role.

_The Phenomenological Mind_ is the first book to properly introduce fundamental questions about the mind from the perspective of phenomenology. Key questions and topics covered include: • what is phenomenology? • naturalizing phenomenology and the cognitive sciences • phenomenology and consciousness • consciousness and self-consciousness • time and consciousness • intentionality • the embodied mind • action • knowledge of other minds • situated and extended minds • phenomenology and personal identity. This second edition includes a new preface, and revised (...) and improved chapters. Also included are helpful features such as chapter summaries, guides to further reading, and a glossary, making _The Phenomenological Mind_ an ideal introduction to key concepts in phenomenology, cognitive science and philosophy of mind. (shrink)

The relationship of self, and self-awareness, and experience: exploring classical phenomenological analyses and their relevance to contemporary discussions in ...

This paper argues for psychological realism in the conception of psychiatric disorders. We review the following contemporary ways of understanding the future of psychiatry: (1) psychiatric classification cannot be successfully reduced to neurobiology, and thus psychiatric disorders should not be conceived of as biological kinds; (2) psychiatric classification can be successfully reduced to neurobiology, and thus psychiatric disorders should be conceived of as biological kinds. Position (1) can lead either to instrumentalism or to eliminativism about psychiatry, depending on whether psychiatric (...) classification is regarded as useful. Position (2), which is inspired by the growing interest in neuroscience within scientific psychiatry, leads to biological realism or essentialism. In this paper we endorse a different realist position, which we label psychological realism. Psychiatric disorders are identified and addressed on the basis of their psychological manifestations which are often described as violations of epistemic, moral or social norms. A couple of examples are proposed by reference to the pathological aspects of delusions, and the factors contributing to their formation. (shrink)

Moral considerations do not appear to play a large role in discussions of the DSM-IV personality disorders and debates about their empirical validity. Yet philosophical analysis reveals that the Cluster B personality disorders, in particular, may in fact be moral rather than clinical conditions. This finding has serious consequences for how they should be treated and by whom.

Given the recent interest in the subjective or phenomenal dimension of consciousness it is no wonder that many authors have once more started to speak of the need for pheno- menological considerations. Often however the term ‘phenomenology’ is being used simply as a synonym for ‘folk psychology', and in our article we argue that it would be far more fruitful to turn to the argumentation to be found within the continental tradition inaugurated by Husserl. In order to exemplify this claim, (...) we criticize Rosenthal's higher-order thought theory as well as Strawson's recent contribution in this journal, and argue that a phenomenological analysis of the nature of self-awareness can provide us with a more sophisticated and accurate model for understanding both phenomenal consciousness and the notion of self. (shrink)

There has been much recent philosophical discussion concerning the relationship between emotion and feeling. However, everyday talk of 'feeling' is not restricted to emotional feeling and the current emphasis on emotions has led to a neglect of other kinds of feeling. These include feelings of homeliness, belonging, separation, unfamiliarity, power, control, being part of something, being at one with nature and 'being there'. Such feelings are perhaps not 'emotional'. However, I suggest here that they do form a distinctive group; all (...) of them are ways of 'finding ourselves in the world'. Indeed, our sense that there is a world and that we are 'in it' is, I suggest, constituted by feeling. I offer an analysis of what such 'existential feelings' consist of, showing how they can be both 'bodily feelings' and, at the same time, part of the structure of intentionality. (shrink)

This chapter offers a novel defence of Szasz’s claim that mental illness is a myth by bringing to bear a standard type of thought experiment used in philosophical discussions of the meaning of natural kind concepts. This makes it possible to accept Szasz’s conclusion that mental illness involves problems of living, some of which may be moral in nature, while bypassing the debate about the meaning of the concept of illness. The chapter then considers the nature of schizophrenia and the (...) personality disorders (PDs) within this framework. It argues that neither is likely to constitute a scientifically valid category, but that nonetheless their symptoms can be scientifically explained. It concludes with a discussion of the way in which Cluster B or ‘bad’ PDs involve failures of virtue or character, and argues that this does not preclude them from being appropriately treated within contemporary, multidisciplinary, mental health services. (shrink)