A family of recent externalist approaches in philosophy of mind argues that our psychological capacities are synchronically and diachronically “scaffolded” by external resources. I consider how these “scaffolded” approaches might inform debates in phenomenological psychopathology. I first introduce the idea of “affective scaffolding” and make some taxonomic distinctions. Next, I use schizophrenia as a case study to argue—along with others in phenomenological psychopathology—that schizophrenia is fundamentally a self-disturbance. However, I offer a subtle reconfiguration of these approaches. I argue (...) that schizophrenia is not simply a disruption of ipseity or minimal self-consciousness but rather a disruption of the scaffolded self, established and regulated via its ongoing engagement with the world and others. I conclude by considering how this scaffolded framework indicates the need to consider new forms of intervention and treatment. (shrink)

Do self‐monitoring accounts, a dominant account of the positive symptoms of schizophrenia, explain auditory verbal hallucination? In this essay, I argue that the account fails to answer crucial questions any explanation of auditory verbal hallucination must address. Where the account provides a plausible answer, I make the case for an alternative explanation: auditory verbal hallucination is not the result of a failed control mechanism, namely failed self‐monitoring, but, rather, of the persistent automaticity of auditory experience of a voice. My (...) argument emphasizes the importance of careful examination of phenomenology as providing substantive constraints on causal models of the positive symptoms in schizophrenia. (shrink)

Temporal experience and its radical alteration in schizophrenia have been one of the central objects of investigation in phenomenological psychopathology. Various phenomenologically oriented researchers have argued that the change in the mode of temporal experience present in schizophrenia can foreground its psychotic symptoms of delusion. This paper aims to further the development of such a phenomenological investigation by highlighting a much-neglected aspect of schizophrenic temporal experience, i.e., its non-emotional affective characteristic. In this paper, it denotes the type of (...) an experience wherein an afflicted individual experiences a pervasive pull or attraction coming from the past, present, and future. By employing Husserl’s account of affection, I argue that such an affectively prominent temporal experience is not yet another abnormality that happens to be present in schizophrenia. Instead, it is indicative of the core disturbance that underpins the schizophrenic temporal mode of experience. I identify such a disturbance as ‘affective modification dysfunction’ and employ it as a core concept with which I synthesize and organise heterogeneous components of schizophrenic temporal experience in their conceptual unity. For the sake of clear description, I organise those components into the following categories: 1.) Time Stop 2.) Ante-festum 3.) Déjà vu/vécu and 4.) Time Fragmentation. I conclude by demonstrating how approaching schizophrenic temporal experience from its affective dimension can further help us better understand its pre-psychotic phase known to precipitate schizophrenic primary delusion, i.e., delusional mood. (shrink)

Scientists, philosophers, and even the lay public commonly accept that schizophrenia stems from a biological or internal ‘dysfunction.’ However, this assessment is typically accompanied neither by well-defined criteria for determining that something is dysfunctional nor empirical evidence that schizophrenia satisfies those criteria. In the following, a concept of biological function is developed and applied to a neurobiological model of schizophrenia. It concludes that current evidence does not warrant the claim that schizophrenia stems from a biological dysfunction, (...) and, in fact, that unusual neural structures associated with schizophrenia may have functional or adaptive significance. The fact that current evidence is ambivalent between these two possibilities (dysfunction versus adaptive function) implies that schizophrenia researchers should be much more cautious in using the ‘dysfunction’ label than they currently are. This has implications for both psychiatric treatment as well as public perception of mental disorders. (shrink)

Schizophrenia is usually described as a fragmentation of subjective experience and the impossibility to engage in meaningful cultural and intersubjective practices. Although the term schizophrenia is less than 100 years old, madness is generally believed to have accompanied mankind through its historical and cultural ontogeny. What does it mean to be “mad”? The failure to adopt social practices or to internalize cultural values of common sense? Despite the vast amount of literature and research, it seems that the study (...) of schizophrenia and of the psychoses is suffering from a generic disintegration. In this introduction, we offer an historical overview of the variety of theories and approaches to schizophrenia. We also provide an overview of how the authors in this volume attempt an integrative account where training, practice, theory and research are considered as parts of a larger whole. This is a varied and pluralistic volume, and it is up to the readers to make use of different chapters according to their own needs. (shrink)

This is a commentary on Humpston, C. S. (2022). “Isolated by Oneself: Ontologically Impossible Experiences in Schizophrenia.” Philosophy, Psychiatry, & Psychology 29(1), 5–15. It is published with an additional commentary by H. Green and Humpston’s response.

Michael Stocker’s “The Schizophrenia of Modern Ethical Theories” attacks versions of consequentialism and deontological ethics on the grounds that they are self-effacing. While it is often thought that Stocker’s argument gives us a reason to favour virtue ethics over those other theories, Simon Keller has argued that this is a mistake. He claims that virtue ethics is also self-effacing, and is therefore afflicted with the self-effacement- related problems that Stocker identifies in consequentialism and deontology. This paper defends virtue ethics (...) against this claim. Although there is a kind of self-effacement invol- ved in the exercise of virtue, this is quite different from the so-called schizophrenia that Stocker thinks is induced by modern ethical theory. Importantly, manifesting virtue does not require one to embrace mutually inconsistent moral commitments, as is at times encouraged by consequentialists and deontologists. This paper also considers a reading of the virtue-ethical criterion of right action that is encouraged by Bernard Williams’s distinction between a de re and a de dicto interpretation of the phrase “acting as the virtuous person would.” I argue that such a reading addresses concerns that a virtue-ethi- cal criterion of right action inevitably generates a problematic form of self-effacement. (shrink)

Explanation of logic of psychoses: schizophrenia and bi-polar, with empirical confirmation - e.g. IQ decreases the likelihood of psychosis, and bi-polar is more likely than schizophrenia... MA thesis in 1998 (Comenius University), Presented at Art exhibition "From Animation", London, Holland Park (W8 6LU), Conferences in Santorini, Daejon, Adelaide 2016.

A recent paper in this journal argues that some cases of schizophrenia should be seen as cases of demon possession and treated by faith healers. A reply, also published in this journal, responds by raising concerns about the intellectual credibility and potentially harmful practical implications of demon possession beliefs. My paper contributes to the discussion, arguing that a critique of demon possession beliefs in the context of schizophrenia is needed, but suggesting an alternative basis for it. It also (...) reflects on important differences between demonic and other forms of spirit possession, and considers the implications of this for mental health care providers. (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)

Background: There is a great deal of overlap between the symptoms of schizophrenia and the nature of yogic experiences described in various societies and religions. Aim: This study aims to separate the symptoms of psychotic disorders from the experiences described by various yogic systems. Materials and Methods: A review of various scriptures like Shrimad Bhagvad Gita, Vedas, and other spiritual literature was done and was compared with the various scientific studies regarding yogic experiences. Results: The result shows that, there (...) exist the abnormal behaviors, which need to be controlled by taking help from psychiatry, but there are also the genuine yogic experiences, that are often confused with the symptoms of a psychotic disorder like schizophrenia. Conclusions: The science of psychiatry is playing an important role in classifying the behavioral patterns and thus helping us to control the abnormal behavior patterns. Still, we cannot deny the fact that, the budding science in a developmental stage is unable to unravel the complete mysteries of human mind and because of that; some genuine yogic experiences are often confused with psychotic 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)

A previously atypical symptom report of a hospitalized patient experiencing unusual visual broadcasting has been documented but has received minimal attention in the research and clinical field of psychiatry. A preliminary hypothesis is proposed of an implicit mechanism of motivation for action and emotional relief functional significance of elevated cortisol and dopamine correlation, that is loosely based on the concept of stress-induced psychosis and which could have led to a concurrent "visual and thought" psychotic episode. In addition, the implication of (...) the effect of increased dopamine on intracranial pressure and indirectly on cerebral perfusion pressure is briefly discussed. A follow-up on the insight and comprehensive understanding of such atypical and novel symptom as an extension of schizophrenia is warranted. (shrink)

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)

"Our literature is replete with complaints about the chaotic state of the systematics of psychoses and every psychiatrist knows that it is impossible to come to any common understanding on the basis of the old diagnostic labels. ... Thus, not even the masters of science can make themselves understood on the basis of the old concepts and with many patients the number of diagnoses made equals the number of institutions they have been too. ... Errors are the greatest obstacles to (...) the progress of science; to correct such errors is of more practical value than to achieve new knowledge. We have here eliminated chaos of terms behind which useful concepts of disease were mistakenly sought; we have eliminated a veritable forest of boundary posts, not one of which indicated any natural line of demarcation. ... By the term „dementia praecox“ or „schizophrenia“ we designate a group of psychoses whose course is at times chronic, at times marked by intermittent attacks, and which can stop or retrograde at any stage, but does not permit a full restitutio ad integrum. The disease is characterized by a specific type of alteration of thinking, feeling, and relation to the external world which appears nowhere else in this particular fashion." Eugen Bleuler. Dementia Praecox or the Group of Schizophrenias. Translated by Joseph Zinkin. International Universities Press, New York, 1950. (shrink)

The following is a mock debate on schizophrenia set in the 1960s at the Sorbonne in Paris, France, between two fictional characters, Dr. Brian L. Zacou, a qualitative sociologist and Institute Professor Emeritus at the University of Prague; Dr. Wytt Thomas, a professor of psychology at Harvard University; two notable historical figures: Dr. Michel Foucault [20th-century philosopher, historian, academic and theorist] and Dr. R. D. Laing [20th-century psychiatrist and experimental researcher and author] and the writer of this compendium [artist (...) and writer Alexej Savreux; himself a diagnosed schizophrenic]. We model it as a transcription of a debate held at that juncture. It explores the historical framework of schizophrenia, the deep-seated aspects and reality of psychosis, a critique of psychiatry, and a sociological perspective on psychosis. We devote the first chapter to the historical framework and an explanation of the reality of schizophrenia. The second chapter is a critique of mainstream psychiatry, and the third chapter is a resolution between the mock debaters on the social framework and how best to come out unscathed in post-modernity. The remarks from Foucault and Laing are paraphrased from the works “Madness and Civilization: A History of Insanity in the Age of Reason” (Foucault) and “The Divided Self: An Existential Study in Sanity and Madness” (Laing) and are annotated with footnotes along with a few other sources. The writer has taken great liberties in constructing this mock debate, including the usage of anachronisms, and also determines his findings based on what we refer to as the anti-symmetry underpinning the biopsychosocial reality of schizophrenia and the social framework that ensues, generated by popular responses to abstract disease concepts associated with insanity. (shrink)

So far, the value dimension underlying affectivity disorders has remained out of focus in phenomenological psychopathology. As early as at the beginning of the 20th century, however, German phenomenologist Max Scheler examined in depth the relationship between affectivity and value dimension through the concept of valueception (Wertnehmung). In this sense, a recent noteworthy contribution has been provided by John Cutting, who has drawn attention to the importance of Scheler’s analyses for psychiatry. In this work I take into consideration only two (...) aspects of Cutting’s proposal: 1) the relationship between the impairments of valueception and the perception of certain value classes; and 2) the interpretation of Scheler’s phenomenological reduction and its juxtaposition with the modus vivendi of schizophrenia. According to Cutting, in the modus vivendi of schizophrenia the valueception impairment entails putting vital values in brackets and focusing on personal values, with a process that recalls Scheler’s phenomenological reduction. Regarding the first aspect, I share Cutting’s starting point, but then shift the focus on how important the valueception is for the intersubjective dimension. In particular, I maintain that rather than compromising the perception of vital values, valueception impairments in the modus vivendi of schizophrenia interfere with the intersubjective dimension and are interwoven with a process of disembodiment. My thesis is that the modus vivendi of schizophrenia involves a disturbance of the intersubjective dimension that arises from the level of valueception and that determines the person’s self-referential closure. With regard to the second point, by analyzing Scheler’s phenomenological reduction, I sustain that its main objective is to increase both the interaction with otherness and the openness to the world (Weltoffenheit). As a consequence, the modus vivendi of schizophrenia, in my opinion, is not comparable, as Cutting claims, with Scheler’s phenomenological reduction, but goes in a different direction. (shrink)

Patients with schizophrenia have a higher risk of cardiovascular diseases and higher mortality from them than does the general population; however, the underlying mechanism remains unclear. Impaired cerebral autoregulation is associated with cerebrovascular diseases and their mortality. Increased or decreased cerebral blood flow in different brain regions has been reported in patients with schizophrenia, which implies impaired cerebral autoregulation. This study investigated the cerebral autoregulation in 21 patients with schizophrenia and 23 age- and sex-matched healthy controls. None (...) of the participants had a history of cardiovascular diseases, hypertension, or diabetes. All participants underwent 10-min blood pressure and cerebral blood flow recording through finger plethysmography and Doppler ultrasonography, respectively. Cerebral autoregulation was assessed by analyzing two autoregulation indices: the mean blood pressure and cerebral blood flow correlation coefficient (Mx), and the phase shift between the waveforms of blood pressure and cerebral blood flow determined using transfer function analysis. Compared with the controls, the patients had a significantly higher Mx (0.257 vs. 0.399, p = 0.036) and lower phase shift (44.3° vs. 38.7° in the 0.07–0.20 Hz frequency band, p = 0.019), which indicated impaired maintenance of constant cerebral blood flow and a delayed cerebrovascular autoregulatory response. Impaired cerebral autoregulation may be caused by schizophrenia and may not be an artifact of coexisting medical conditions. The mechanism underlying impaired cerebral autoregulation in schizophrenia and its probable role in the development of cerebrovascular diseases require further investigation. (shrink)

A number of cognitive and behavioral variables influence the performance in tasks of theory of mind (ToM). Since two of the most important variables, memory and explicit expression, are impaired in schizophrenic patients, the ToM appears inconsistent in these patients. An ideal instrument of ToM should therefore account for deficient memory and impaired ability of these patients to explicitly express intentions. If such an instrument is developed, it should provide information that can be used not only to understand the pathophysiology (...) but also to monitor patients. (shrink)

Objectives: The growing rate of retraction of scientific publications has attracted much attention within the academic community, but there is little knowledge about the nature of such retractions in schizophrenia-related research. This study aimed to analyze the characteristics of retractions of schizophrenia-related publications.

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)

This research focuses on Schizophrenia and Clairaudience that is part of doctoral research for a Doctorate of Metaphysical Sciences at the University of Metaphysics. The mental illness known as Schizophrenia has been known for centuries. There are various symptoms associated with this mental illness upon which a diagnosis is based. The exact causes of the mental illness Schizophrenia remain unknown, as does the actual part of the individual which is effect by the illness. The most prominent and (...) definable symptom of Schizophrenia remains to be auditory hallucinations. Another explanation for individual's being able to hear voices, is that of clairaudience, a psychic ability. Clairaudient ability has a positive connotation upon the ability to hear voices, whereas the diagnosis of Schizophrenia is most commonly treated with pharmaceutical drugs to reduce or eliminate symptoms. This paper involves information about Schizophrenia, how it is perceived and treated. It also discusses various views of clairaudience, and how it is effective and manageable. A new approach is required to the medical industry when individuals are being treated for a diagnosis of Schizophrenia. (shrink)

I offer a preliminary examination on the importance of narrative for helping to overcome the issue of stigma surrounding mental illness, specifically schizophrenia. I maintain that engaging with first-person accounts of schizophrenia allows caregivers, and the broader general public, to better understand the phenomenological lived experiences of persons living with this mental health challenge and to better understand the experience of dealing with stigma. In doing so, I maintain that both caregivers and the public can begin developing more (...) accepting views of schizophrenia and begin to support those who need it the most. (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)

This article provides an introduction to a special issue of the journal Philosophy, Psychiatry and Psychology, On Understanding and Explaining Schizophrenia. The article identifies a common thread running through the different contributions to this special issue, inspired by Jaspers's (1963) suggestion that a profound impairment in the ability to engage in interpersonal and social relations is a key factor in psychiatric disorders. It is argued that this suggestion can help solve a central dilemma in psychopathology, which is to make (...) intelligible the emergence and nature of psychiatric phenomena involving disturbances of rationality, intentionality and self-consciousness, whilst at the same time accounting for a sense in which such phenomena resist understanding. (shrink)

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)

Objective: Alterations in psychomotor dimension cut across different psychiatric disorders, such as schizophrenia (SCZ) and bipolar disorder (BD). This preliminary study aimed to investigate the organization of intrinsic brain activity in the subcortical-cortical sensorimotor system in SCZ (and BD) as characterized according to psychomotor dimension. -/- Method: In this resting-state functional magnetic resonance imaging (fMRI) study, functional connectivity (FC) between thalamus and sensorimotor network (SMN), along with FC from substantia nigra (SN) and raphe nuclei (RN) to basal ganglia (BG) (...) and thalamic regions, were investigated by using an a-priori-driven and dimensional approach. This was done in two datasets: SCZ patients showing inhibited psychomotricity (n = 18) vs. controls (n = 19); SCZ patients showing excited psychomotricity (n = 20) vs. controls (n = 108). Data from a third dataset of BD in inhibited depressive or manic phases (reflecting inhibited or excited psychomotricity) were used as control. -/- Results: SCZ patients suffering from psychomotor inhibition showed decreased thalamus-SMN FC toward around-zero values paralleled by a concomitant reduction of SN-BG/thalamus FC and RN-BG/thalamus FC (as BD patients in inhibited depression). By contrast, SCZ patients suffering from psychomotor excitation exhibited increased thalamus-SMN FC toward positive values paralleled by a concomitant reduction of RN-BG/thalamus FC (as BD patients in mania). -/- Conclusions: These findings suggest that patients exhibiting low or high levels of psychomotor activity show distinct patterns of thalamus-SMN coupling, which could be traced to specific deficit in SN- or RN-related connectivity. Notably, this was independent from the diagnosis of SCZ or BD, supporting an RDoC-like dimensional approach to psychomotricity. (shrink)

Many philosophers and psychologists have sought to explain experiences of auditory verbal hallucinations and “inserted thoughts” in schizophrenia in terms of a failure on the part of patients to appropriately monitor their own inner speech. These self-monitoring accounts have recently been challenged by some who argue that AVHs are better explained in terms of the spontaneous activation of auditory-verbal representations. This paper defends two kinds of self-monitoring approach against the spontaneous activation account. The defense requires first making some important (...) clarifications concerning what is at issue in the dispute between the two forms of theory. A popular but problematic self-monitoring theory is then contrasted with two more plausible conceptions of what the relevant self-monitoring deficits involve. The first appeals to deficits in the neural mechanisms that normally filter or attenuate sensory signals that are the result of one’s own actions. The second, less familiar, form of self-monitoring approach draws an important analogy between Wernicke’s aphasia and AVHs in schizophrenia. This style of self-monitoring theory pursues possible connections among AVHs, inserted thoughts, and the disorganized speech characteristic formal thought disorder. (shrink)

We respond to Moseley and Wilkinson's defense of inner speech models of AVH.

There has recently been emphasis put on providing two-factor accounts of monothematic delusions. Such accounts would explain (1) whether a delusional hypothesis (e.g. someone else is inserting thoughts into my mind) can be understood as a prima facie reasonable response to an experience and (2) why such a delusional hypothesis is believed and maintained given its implausibility and evidence against it. I argue that if we are to avoid obfuscating the cognitive mechanisms involved in monothematic delusion formation we should split (...) the first factor (1 above) into two factors: how abnormal experience can give rise to a delusional ‘proto-hypothesis’ and how a ‘proto-hypothesis’ in consort with normal experiences and background information, can be developed into a delusional hypothesis. In particular I will argue that a schizophrenic is faced with the unusual requirement of having to identify an introspectively accessible thought as one's own, and that this requirement of identification is the central experiential abnormality of thought insertion, auditory verbal hallucination, and alien control (i.e. passivity symptoms). Additionally, I will consider non-experiential factors which are required for the formation of a delusional hypothesis. (shrink)

What we call today negative symptoms are thought to descend from the very deficits that the earliest scholars of schizophrenia (such as Kraepelin and Bleuler) considered to be the key, fundamental symptoms of the disorder. In the latter half of the 20th century, delusions and hallucinations received greater prominence, which eventually changed both the concept of schizophrenia and its diagnostic criteria by placing positive symptoms at the forefront. The first decade of the 21st century witnessed a resurgence of (...) interest in negative symptoms of schizophrenia. Persistent and clinically significant negative symptoms were declared an unmet therapeutic need in a large proportion of cases by several schizophrenia experts, who, with the support of the NIMH, held a consensus development conference in 2005 to discuss negative symptoms and how to proceed in this area. The Consensus Statement read that improved recognition and awareness of negative symptoms are the fi rst step to improving function in patients with negative symptoms of schizophrenia. According to the principles of Values-Based Practice that also means improving recognition and awareness of the diverse values involved in the conceptualization and practical assessment of negative symptoms. By analyzing selected conceptual papers on negative symptoms, instruments developed for the assessment of this area of psychopathology, and clinical vignettes, we intend to point out some values-related issues in the diagnosis of negative symptoms as well as to make the case that these symptoms may be a particularly complex aspect of schizophrenia, vis-à- vis understanding the role played by values. (shrink)

The professional application of ethics often lacks the necessary conceptual tools to construct adequate theoretical foundations that can be used for practical enterprise. This book focuses on an anthropological approach to mental illness, describing how schizophrenia can distort one's experience of empathy and of the presence in the world through pathological indifference. It describes factual and phenomenological perspectives on a case of schizophrenia, based on the method of Eugène Minkowski.

Existential a prioris are fundamental elements of the a priori structure of one's being-in-the-world. They relate to Heidegger's existentials, although in psychiatry the analysis is mainly at the ontic level of concrete existence. The English term "existential" does not discriminate between the German "existenziell" and "existenzial". Here we mean with "existential" what in German is called "existenziell". In this paper schizophrenic delusions and hallucinations are considered secondary phenomena, being founded in a primary alteration of the existential a prioris. In (...) class='Hi'>schizophrenia the alteration of the existential a prioris is recognized as a certain mode of being, different from ours, which is evident in the alteration of spatialization and temporalization, being-with others and bodily being. This is discussed by the so-called technical delusions and hallucinations, which are psychotic symptoms experienced as being infl uenced by means of technical instruments. The recognition of the alteration of these basic pre-objective structures is very important for the understanding and therapy of people with schizophrenia. (shrink)

Schizophrenia is often associated with other physical and mental problems. Generalized anxiety disorder is notably one of the comorbid disorders which is often linked to schizophrenia. The association of polythematic delusions and of ideas resulting from generalized anxiety disorder complicates the exercise of the corresponding cognitive therapy, for the resulting ideas are most often inextricably intertwined. In what follows, we endeavour to propose a methodology for the differential treatment of polythematic delusions inherent to schizophrenia when combined with (...) ideas originating from generalized anxiety disorder. We propose, with regard to the corresponding content of delusions, an analysis which allows under certain conditions, to separate the content associated with polythematic delusions and the one that relates to generalized anxiety disorder, in order to facilitate the exercise of the corresponding cognitive therapy. (shrink)

Self-disorders in depression and schizophrenia have been the focus of much recent work in phenomenological psychopathology. But little has been said about the role the material environment plays in shaping the affective character of these disorders. In this paper, we argue that enjoying reliable (i.e., trustworthy) access to the things and spaces around us — the constituents of our material environment — is crucial for our ability to stabilize and regulate our affective life on a day-today basis. These things (...) and spaces often play an ineliminable role in shaping what we feel and how we feel it; when we interact with them, they contribute ongoing feedback that " scaffolds " the character and temporal development of our affective experiences. However, in some psychopathological conditions, the ability to access to these things and spaces becomes disturbed. Individuals not only lose certain forms of access to the practical significance of the built environment but also to its ​ regulative​ significance, too — and the stability and organization of their affective life is compromised. In developing this view, we discuss core concepts like " affordance spaces " , " scaffolding " , and " incorporation ". We apply these concepts to two case studies, severe depression and schizophrenia, and we show why these cases support our main claim. We conclude by briefly considering implications of this view for developing intervention and treatment strategies. (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)

Taking into account some basic epistemological considerations on psychoanalysis by Ignacio Matte Blanco, it is possible to deduce some first simple remarks on certain logical aspects of schizophrenic reasoning. Further remarks on mathematical thought are also made in the light of what established, taking into account the comparison with the schizophrenia pattern.

We proceed to describe a model for the formation and maintenance of polythematic delusions encountered in schizophrenia, which is in adequacy with Brendan Maher's account of delusions. Polythematic delusions are considered here as the conclusions of arguments triggered by apophenia that include some very common errors of reasoning such as post hoc fallacy and confirmation bias. We describe first the structure of reasoning which leads to delusions of reference, of telepathy and of influence, by distinguishing between the primary, secondary, (...) tertiary and quaternary types of delusional arguments. These four levels of arguments correspond to a stage the nature of which is respectively instantial, inductive, interpretative at a monothematic level and interpretative at a polythematic level. We also proceed to identify accurately the fallacious steps in the corresponding reasoning. We expose then the role of apophenia in the elaboration of delusional ideas. Lastly, we describe the role played by the hallucinations in the present model. (shrink)

Affordances are action-possibilities, ways of relating to and acting on our world. A theory of affordances helps us understand how we have bodily access to our world and what it means to enjoy such access. But what happens to bodies when this access is somehow ruptured or impeded? This question is relevant to psychopathology. People with psychiatric disorders often describe feeling as though they’ve lost access to affordances that others take for granted. Focusing on schizophrenia, depression, and autistic spectrum (...) disorder, I argue that thinking about the bodily consequences of losing access to everyday affordances can help us better understand these reports. An affordance-based approach to psychopathology can illuminate some of the causes, as well as the experiential character and content, of affective disorders in psychopathology. It can also draw our attention to some under-explored ethical and political dimensions of these issues needing further consideration. (shrink)

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of mental disorders. I (...) articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry. (shrink)

This contribution retraces the most significant moments of a debate that has seen researchers from different disciplinary areas reflect on schizophrenia, in particular on the symptom of thought insertion, with the conceptual tools of Kant’s theoretical philosophy. In the course of this report, some problematic aspects of the interpretations of the "Critique of Pure Reason" promoted in the aforementioned debate are highlighted. The last part of the contribution presents some considerations on the relationship between critical philosophy and madness.

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)

Not only defi ning the nature of schizophrenia, but even defi ning schizophrenia as a diagnostic entity is still a challenge for psychiatry. The current diagnostic systems and the related approach to psychopathology are of little aid to this purpose, and have inadvertently resulted in an impoverished clinical practice. There is substantial meaning underlying schizophrenic symptoms that would appear bizarre and senseless from the viewpoint of a purely descriptive method. Psychiatry needs to devise an approach that embraces the (...) complexity of the different perspectives of explanation and understanding of mental illness, examining the interplay of each element in the subjective experience. Symptoms such as delusion and hallucinations cannot merely be conceptualized as false judgment or lacking of external object, respectively, as they refl ect the fact that patients try to make sense of their different, globally altered experience of the self, of others and of the world. This line of reasoning builds on previous work in the phenomenological tradition postulating a disturbance in sensorimotor processes, which bond human beings with one another while remaining imperceptible to consciousness. This suggestion is consistent with a large body of research highlighting impairment in sensory processing in schizophrenia. Other authors underscored the importance of subtle alterations of functions other than sensorimotor processes, such as experiential anomalies of affectivity, cognition-perception and body-motor experience, alterations of self-awareness, and disturbances in reciprocal attunement leading to disconnection from a common register of meanings and loss of common sense. Heidegger refers to a human being as Being intrinsically selfrevelatory in the unity of physis and logos. He refers to the lived experience of being constantly in the everyday situation as being located, “thrown” into the world. The existence is always ‘in the world’, ‘near the things’ and ‘with the others’ for everybody, in the ways of ‘attunement’, ‘understanding’ and ‘discourse’, that are always together, in the unity of the Dasein. This conception of human existence may help understand the subjective experience of a schizophrenic patient and increase diagnostic accuracy and treatment adequacy. (shrink)

The article is devoted to an objective assessment of the role of Sabina Spielrein – one of the Russian pioneers of psychoanalysis – in the forming of theoretical basis of analytical psychology. A bibliographic review precedes the main part, in order to show the prevailing bias towards the consideration of personal life and the subjective features of Spielrein’s creativity, and not her ideas. In the first part the author briefly considers Spielrein’s contribution to the empirical justification and further development of (...) the complex theory and shows how her ideas are related to Jung's representations on the phylogenesis and ontogenesis of the psyche as a result of complex building-up and about the psychogenesis of schizophrenia. In particular, it is noted that Spielrein is the first one who clearly formulate a hypothesis, according to which our psyche a priori does not constitute anything integral, but is a combination of many complexes. In the second part the author focuses on the concept of speciespsyche, which anticipates the concept of collective unconscious. He draws parallels between the ideas of Spielrein and Jung on the role of collective unconscious contents of the psyche in shaping the individual's current psychic experience. In particular, the author focuses on the idea that every experience is always both conscious and unconscious, and if it does not superimpose the entire history of similar experiences inherited from the ancestors then it does not reach the needed level of intensity. In the same part the author points out three factors that do not allow us to assert with complete confidence that the concept of species-psyche is the exclusive merit of Spielrein, even though she published her ideas before Jung. The third part gives an assessment of the contribution of Spielrein to the development of Jung’s and Freud’s views on the destruction. The author points out the two main sources of Spielrein’s reflection on the destruction nature. The first is the ideas of the Russian biologist I.I. Mechnikov concerning the instinct of normal death. The second is Jung's ideas about the ambivalent nature of the libido. The author also demonstrates the close connection between the notion of species-psyche and the concept of destruction. Then a distinction is made between the simple static instinct of self-preservation and the ambivalent dynamic instinct of preservation of the species. In addition, the author compares Spielrein’s and Jung’s views on the essence of the destruction with the views of Freud. For this purpose a distinction is made between the death instinct as a positive drive for transformation through the destruction and the death instinct as the drive to completely destruction or stop of all processes. Дается оценка роли С.Н. Шпильрейн в формировании теоретического базиса аналитической психологии. Демонстрируется значимость ее научного вклада в развитие представлений К.Г. Юнга о комплексе, фило- и онтогенезе психики, психогенезе шизофрении, коллективном бессознательном и деструкции. Особый акцент делается на последние два момента. Кроме того, выявляются некоторые различия в понимании сущности феномена деструкции С.Н. Шпильрейн, К.Г. Юнгом и З. Фрейдом. (shrink)