The task of being oneself lies at the heart of human existence and entails the possibility of not being oneself. In the case of schizophrenia, this possibility may come to the fore in a disturbing way. Patients often report that they feel alienated from themselves. Therefore, it is perhaps unsurprising that schizophrenia sometimes has been described with the heideggerian notion of inauthenticity. The aim of this paper is to explore if this description is adequate. We discuss two phenomenological accounts of (...) schizophrenia: Binswanger’s account of schizophrenia as a form of inauthenticity and Blankenburg’s account of schizophrenia as a loss of common sense, which seems construable as a loss of inauthenticity. We argue that the accounts are highlighting aspects of the same underlying phenomenon, viz. schizophrenic autism. Moreover, we argue that Binswanger’s description of schizophrenia as a form of inauthenticity is inadequate and we discuss experiences of self-alienation in schizophrenia. (shrink)

In addition to discussing some philosophical accounts of common sense, this article considers several ways in which common sense can be altered or disturbed in psychopathology. Common sense can be defined as practical understanding, capacity to see and take things in their right light, sound judgment, or ordinary mental capacity. The philosopher Vico described it as the ability to distinguish the probable from the improbable. Goethe understood common sense as an "organ" that is formed in communication for the purpose of (...) communication. Common sense is rooted in the intersubjective constitution of the life-world. Obsessive-compulsive patients show relatively mild disturbances of common sense. Patients with major affective psychoses, in their premorbid personality structure, are overly attached to common sense. In schizophrenia, however, there seems to be a true abdication of common sense involving a loss of "natural self-evidence." Even in premorbid states, such persons often lose both the sense of tact and the ability to "take things in their right light." Although logic, and the ability to engage in theoretical discussion, may be preserved, there is a loss of interpretive skills and the "faculty of judgment"; this results in an inability to cope with everyday practical and social activity. There is also a characteristic sense of perplexity, a sense of amazement before that which would normally seem self-evident and a frequent tendency to reflect upon the conditions of possibility of existence that otherwise remain concealed. The author suggests that the fragility of common sense should not be seen as a mere deficiency state. Rather, it derives from a basic vulnerability inherent in the very structure of being human. (Abstract written by special issue editor: L.A.S.). (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)

We are glad to acknowledge the wide spectrum of topics posited by our commentators and at the same time the recognition of the thematic issue of our project: that the mentally ill is still a person, and that this humane dimension of his existence must be brought to the fore in psychopathological studies and kept always in the fore in the therapeutic process.We are also glad to have encountered appreciation for the fact that long gone is the time when the (...) clinician could have afforded to be the plenipotentiary in the therapeutic relationship, and that a more equal geometry of relations with the patient is not only useful but probably necessary for therapeutic success, intended as a "success [that] also involves... (shrink)

The end of human history is an event that has been foreseen or announced by both messianics and dialecticians. But who is the protagonist of that history that is coming—or has come—to a close? What is man? How did he come on the scene? And how has he maintained his privileged place as the master of, or first among, the animals? In The Open, contemporary Italian philosopher Giorgio Agamben considers the ways in which the “human” has been thought of as (...) either a distinct and superior type of animal, or a kind of being that is essentially different from animal altogether. In an argument that ranges from ancient Greek, Christian, and Jewish texts to twentieth-century thinkers such as Heidegger, Benjamin, and Kojève, Agamben examines the ways in which the distinction between man and animal has been manufactured by the logical presuppositions of Western thought, and he investigates the profound implications that the man/animal distinction has had for disciplines as seemingly disparate as philosophy, law, anthropology, medicine, and politics. (shrink)

Can delusions, in the context of psychosis, enhance a person’s sense of meaningfulness? The case described here suggests that, in some circumstances, they can. This prompts further questions into the complexities of delusion as a lived phenomenon, with important implications for the clinical encounter. While assumptions of meaninglessness are often associated with concepts of ’disorder’, ’harm’ and ’dysfunction’, we suggest that meaning can nonetheless be found within what is commonly taken to be incomprehensible or even meaningless. A phenomenological and value-based (...) approach appears indispensable for clinicians facing the seemingly paradoxical coexistence of harmfulness and meaningfulness. (shrink)

Schizophrenia involves profound but enigmatic disturbances of affective or emotional life. The affective responses as well as expression of many patients in the schizophrenia spectrum can seem odd, incongruent, inadequate, or otherwise off-the-mark. Such patients are, in fact, often described in rather contradictory terms: as being prone both to exaggerated and to diminished levels of emotional or affective response. According to Ernst Kretschmer, they actually tend to have both kinds of experience at the same time. This paper attempts to explain (...) what might be termed this 'Kretschmerian paradox'. Some relevant concepts and vocabulary for affect and emotion are discussed . The need for a phenomenological approach focusing on subjective experience is suggested. Three modes of abnormal experience in schizophrenia are investigated in light of their implications for affect or emotion: alienation of the lived body ; fragmented perception and loss of affordances ; and preoccupation with a quasi-delusional world created by the self. (shrink)

This paper considers the nature of schizophrenic autism and urges its importance for understanding the phenomenological core of schizophrenia. Different clinical manifestations of schizophrenic autism are demonstrated, and it is asked whether these might reflect different aspects of one underlying phenomenologically intelligible phenomenon. Four phenomenological hypotheses are put forward: that autism is a function of semantic drifting, emotional drifting, ontological incompleteness, or a particular ethic rejecting common sense. By way of conclusion an integrative hypothesis is considered: that autism is intelligible (...) in terms of the experience of disembodiment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 323-326 [Access article in PDF] The Tacit Dimension Thomas Fuchs Thirty years after its appearance, Blankenburg's "Psychopathology of common sense" has not lost its relevance. In my commentary I will try to illustrate the fruitfulness of his approach by pointing to some connections with the phenomenology of the body as well as with recent memory and infant research.As Blankenburg himself indicates, the notion (...) of common sense developed by a shift of meaning from the classical sensus communis and thus has its original basis in the sensual-bodily experience. By the koinè aísthesis, Aristoteles meant a central sense organ integrating all single modalities of sensation (which he localized in the heart). In German physiology and psychiatry of the nineteenth century, the sensus communis was still translated as "Gemeingefühl" ("common feeling") or "cenesthesia" (Fuchs 1995). This term denoted the inner, proprioceptive bodily sensations, but also an original unity of the senses, which has been rediscovered by recent infant research as intermodal sensory perception. The affection of the body was thus regarded as the common basis of all sensation.Looking on this track for a bodily basis of the common sense, we find it in the habitual structure of the lived-body as analysed by Merleau-Ponty (1945). The body is the primary "matter-of-course," namely, the tacitly functioning medium of our everyday being-in-the-world prior to any subject-object split. The body schema, in Merleau-Ponty's view, is not only a system of familiar units of movement or "kinetic melodies," it also incorporates the surrounding things, tools, and spaces that are familiar to us and that we "inhabit." Thus, the musician "does not only manipulate the instrument like a separate object, but lives in it like a limb and inhabits the expressive musical space it opens" (Behnke 1997). But for Merleau-Ponty, the body schema is also the basis of "intercorporeity," i.e., a prepersonal sphere of reciprocal comportment and understanding prior to any explicit consensus and symbolic communication. In this sphere of elementary contact, the "atmospheric" senses play a major role: The sense of smell (as shown, e.g., by the expression "to scent treason" or in German, "jemand nicht riechen können" [not be able to "smell" or stand someone]) as well as the sense of taste whose ambiguous meaning, mentioned by Blankenburg, points to the bodily basis of the feeling for what is suitable, decent, or aesthetically pleasing. Even the designation of homo sapiens that we give to ourselves is derived from the latin sapere (to taste/to know), and thus shows that the knowledge characteristic for man is not an explicit one, but an intuitive, implicit knowing or "feel" for his surroundings, or as Kant says, an "aesthetic rather than intellectual judgment" (cited by Blankenburg).Polanyi (1967) has analysed this knowledge at the roots of common sense as "tacit knowledge." It is based on processes of Gestalt formation that enable us to grasp unified wholes through their constituting elements without still being aware of the latter. Thus, we understand the facial expression of others immediately but cannot tell from which details. Or we know how [End Page 323] to waltz without knowing the single movements or being able to explain it. Tacit knowledge implies all the taken-for-granted that we have forgotten once it has become our second nature and part of our bodily habits. It is mainly based on the neuronal coupling of single sensori-motor units by repeated perception or action. This unconscious knowing has only recently come to be explored by psychology under the heading of "implicit" or "procedural memory" (Schacter 1987, 1996). It contains familiar styles or "melodies" of moving, perceiving, and being-with-others in which our whole bodily and emotional experience is engaged. There is an atmospheric, "felt" quality about them that cannot be analysed into single elements. Implicit knowledge may, therefore, never be wholly expressed by words—it is only realized in the concrete situation. It may only be circumscribed by expressions such as "how it feels...," "how it is...," e.g., how it is... (shrink)