In contemporary philosophy of mind and psychiatry, schizophrenic thought insertion is often used as a validating or invalidating counterexample in various theories about how we experience ourselves. Recent work has taken cases of thought insertion to provide an invalidating counterexample to the Humean denial of self-experience, arguing that deficiencies of agency in thought insertion suggest that we normally experience ourselves as the agent of our thoughts. In this paper, I argue that appealing to a breakdown in the sense of agency (...) to explain thought insertion is problematic, and that rather than following the prevailing binary approach which holds that certain features of consciousness go missing while others remain wholly intact, a better explanation involves construing thought insertion as a disturbing or disrupting of the subjectivity (for-me-ness) of experience. The result is that experiencing ourselves as the subject of our thoughts is where future research should be directed, given the robust persistence of this form of self-experience across psychopathological and non-psychopathological cases alike. (shrink)

This essay describes some of the literary, psychological, and historical causes of Russia’s war in Ukraine (2022) based on observations of the national character found in the fiction of Aleksandr Pushkin and Fyodor Dostoevsky and in philosophical and psychological essays of Petr Chaadaev, Sergei Askol’dov, and Sigmund Freud. The political ideology that stands behind the war can be characterized as schizofascism, or schizophrenic fascism that embraces the contradiction between archaic myths, chauvinism, and xenophobia, on the one hand, and corruption and (...) cynicism, on the other. Citing the controversial results of sociological polls indicating both Russians’ aspiration for friendship with Ukraine and their support for the aggressive war, the author explores the deep ambivalence inherent in the psychology of Russians as historical successors of the Golden Horde and the Moscovite State, incorporating the legacy of nomadism, militarism, messianism, and autarky. (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)

This paper offers a biosemiotic account of the poetic aspects of gesture and speech in schizophrenia. The argument is that speech and gesture are not the mere expression of pre-verbal thoughts. Instead, meaning is enacted by the temporal and semantic coordination of speech and gesture. The bodily basis of language is highlighted by the fact that, failing to create language that is organized around topics, individuals with schizophrenia often rely on poetic associations in directing their utterances. Accordingly, the analysis of (...) schizophrenic speech and gesture based on McNeill’s Growth Point theory is enriched with reference to both Cowley’s (2007b) views on language as distributed social coordination, and Alexander’s (Biosemiotics 2(1):77–100, 2009) description of formal causes in nature. Schizophrenic language can be seen as a hypertrophied manifestation of the discourse-scaffolding function of poetic associations in speech and gesture. The analysis of schizophrenic language shows that language behavior need not be built on pre-verbal thoughts and important aspects of schizophrenic language, such as metalinguistic awareness and semiotic agency, can be clarified by applying concepts from biosemiotics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Schizophrenic Delusions, Embodiment, and the BackgroundGiovanni Stanghellini (bio)Keywordsschizophrenia, delusion, embodiment, common sense, phenomenologyIn their article Delusions, Certainty, and the Background, Rhodes and Gipps (2008) argue for a Background theory of delusions. Their central argument may be summed up as follows:• The formation and maintenance of delusions becomes intelligible once they are seen to reflect a basic disturbance. When studying delusions, the focus should be on providing an adequate framework (...) for understanding, rather than providing empirical hypotheses to be tested.• The basic disturbance in delusions, and insanity in general, is not a deficiency in reasoning or a defect in the content of experience, but rather something more fundamental.• Delusions––this is their central claim––are caused by a failure of the Bedrock of beliefs (Wittgenstein) or the Background (Searle) to adequately inform or constrain the process of belief formation.• Our Bedrock certainties are defined––following Wittgenstein––as ultimately constituted by our ability to act in the world and demonstrate our primary engagement with the world. They are born out of our everyday experience of the world, conveying our direct, pre-reflective, and practical grasp of the world, rather than expressing judgments we make about it.• Similarly, the Background is defined as those abilities and dispositions that are neither representations nor rules, that function before we can make sense of our experiences.• Wittgenstein’s Bedrock and Searle’s Background in great part overlap with Blankenburg’s pre-reflective natural self-evidence and Stanghellini’s common sense, namely, our own unreflecting know-how, a set of nonpropositional skills, capacities, and dispositions that attune us with the world.• Without a fully functioning Background, the distinctions between imaginary and real (mind and world), self and non-self, and cause and coincidence fail to be adequately drawn within experience. Also, grasping the meaning of others’ behaviors and a weakening of contextual influences are entailed by an erosion of Background sensibilities.I feel extremely sympathetic to this account and, as Rhodes and Gipps report, there are remarkable points of overlap between their and my own ideas about the formation of schizophrenic delusions. I would like to add some comments on the main theories on the basic disorders entailed in the pathogenesis of delusions and conclude with some suggestions to integrate the Background theory of delusions. [End Page 311]Syntagmatic Versus Paradigmatic Models of DelusionsLet me raise first an epistemological point: paradigmatic models of delusions––defining what a delusion is in itself and what are its borders with similar phenomena––proved to be unsatisfactory in psychopathology. As Schneider and Huber (1975) put it more that 40 years ago, “[w]hat counts in delusions is not the delusion itself... but snagging the course of the lived experience, rather than its product” (p. 2042). What we do need, to understand what delusions really are, are syntagmatic models how––delusions (in this case, delusions in persons with schizophrenia) are connected to other phenomena within a structure or a process. What we should look for, then, are the phenomena that contribute as motivationally (or causally) necessary vulnerability, that is, the basic disturbance for the development of delusions. This logically implies that we need studying delusions in fieri, or the pathways that lead to delusions themselves. I subscribe to the principle that studying delusion by merely concentrating exclusively on its crystallized forms would be like studying stroke victims to know more about hypertension (Parnas and Sass 2001). This methodological move from crystallized delusions to delusions in-the-making is quintessential to define the subtle, basic, phenomenal invariant core that characterizes a given psychopathological phenomenon and that emerges across the manifold facets of the phenomenon itself and shapes them and keeps them meaningfully interconnected.A syntagmatic model should account for (at least) the following features of schizophrenic delusions:• abnormalities in symbolization (loss of commonsense meaning of a given thing or fact),• formal aspects (e.g., revelation character, experience of centrality), and• specificity of content (e.g., metaphysical tinge).It should also be compatible with those phenomena like self-disorders (loss of sense of ownership and of agency) that are entailed in most schizophrenic symptoms (e.g., verbal–acoustic hallucinations and experiences of alien control). Finally, it should keep meaningfully... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychodramatic Psychotherapy for Schizophrenic IndividualsJohn Nolte, MD, PhD (bio)As a long-time student, practitioner, trainer, author and advocate of J. L. Moreno, MD,’s works and specifically the psychodramatic method, I am always appreciative of efforts, like Chapy’s, to commend and advocate for psychodrama. This is especially so because for a time, Moreno and psychodrama were heavily criticized, even maligned in the mental health professions. At the same time, considering how (...) poorly Moreno and his methods have been understood as well as the difficulty of accessing his original material, I feel an obligation to set the record straight when confronted with incomplete, inadequate, or sometimes incompetent expositions of Moreno’s psychodrama.Chapy’s article recommends psychodrama as a treatment method for schizophrenic people by calling upon existentialist and phenomenological concepts. Psychodrama, he proposes, opens up existence by allowing “schizophrenic patients to incorporate the experience of an ‘absolutely other.’”There are major flaws in Chapy’s presentation. His “clinical illustration,” the presentation of a psychodrama with a schizophrenic patient, while it may be considered psychodrama under the broadest definition of the term, hardly fulfills the requirements of a psychotherapeutic psychodrama. We must question the competence of the psychodramatist in Chapy’s example. Chapy’s description of the drama itself falls short of being an adequate account of a psychodrama, failing to convey the emotional intensity and realness which a well directed and reported psychodrama achieves. We do not learn, for example, if Damien’s perception of his father is introduced through role reversal with the father, a standard psychodramatic technique which is done in order to give the auxiliary ego taking that role an understanding how Damien experiences his father. We do not know if role reversals are made throughout the drama so that Damien can experience how he is perceived by father, can feel the force of his confrontation in the role of father, and is required to reply as his father to his confrontation. We are given little information about the psychodramatic techniques employed by the director other than the scene setting of the studio in which the psychodramatic [End Page 227] encounter takes place, and the soliloquy in which Damien expresses his worry and hopes for the outcome of the confrontation. It should be clear in the description of the drama whether the father’s statements in the drama were produced by Damien in role reversal, or by the auxiliary ego playing the role. There is a difference and it is significant. Although we are told that Damien “evokes a systematic relationship between him and his father” during the psychodrama, we do not see how this happens. Every psychodrama is an existential experience and its description should fully communicate its meaning and emotion.A more serious problem, however, is that this drama does not deal with Damien’s psychosis. Although Damien may be diagnosed as schizophrenic, his disorder is obviously in remission or controlled by psychotropic drugs. The drama reveals none of the hallucinations, delusions, or disorder characteristic of schizophrenic disorders. It could be psychodrama of any young man with a complaint about his father.The notion that people with schizophrenia can be successfully treated by psychodrama is not new. Moreno began developing psychodramatic psychotherapy at his Beacon Hill Sanitarium, established in 1936. He and psychodrama gained some fame because of his success in treating schizophrenic patients at a time when schizophrenic individuals were considered incapable of benefitting from psychotherapy. Moreno’s approach to the treatment of schizophrenic patients was much more robust than the psychodrama described by Chapy. During a psychotic attack, the individual’s perception of the world and self are distorted in ways that made action and interaction in the world of conventional reality impossible. Additionally, the psychotic episode makes the psychotic person incapable of being comprehended by anyone else, including the psychiatrist. Moreno’s solution was to make the chaotic, bewildering, sometimes violent and always terrifying inner world visible and tangible in the surplus reality of the psychodramatic stage. In moments of lucidity following the psychotic episode, he asked his schizophrenic patients to reenact their psychotic experiences. The result was that, “In this imaginary reality on the psychodramatic stage, the... (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 present study is aim to discuss the gender differences in recovery and Quality of life among schizophrenic patients of Asghar Psychiatric hospital Karachi. A sample of 70 patients including male and female was selected. Only patients with schizophrenia in recovery were selected in study purpose. Purposive sampling method was used to select the sample. All patients were screened using Demographic sheets, RAS-DS and WHOQOL-BRIEF to be administered to the sample. The result of the study indicated that significant differences of (...) recovery score among male and female respondents were found. Female patients were higher scores of recovery with regards to all domains of RAS-DS and the males showed significantly better quality of life with regards to all domains: Physical health, Psychological health, Environment and Social relations than females. (shrink)

This article addresses questions about the sense of agency and its distinction from the sense of ownership in the context of understanding schizophrenic thought insertion. In contrast to “standard” approaches that identify problems with the sense of agency as central to thought insertion, two recent proposals argue that it is more correct to think that the problem concerns the subject’s sense of ownership. This view involves a “more demanding” concept of the sense of ownership that, I will argue, ultimately depends (...) on the sense of agency. In this regard, the sense of agency still appears to be the originating problem. (shrink)

I thank Dr. Matthew Parrott and Dr. V.Y. Allison-Bolger very much for their valuable comments on my paper. They have given me the chance to reflect further on the account of thought insertion I propose, and I respond to them with enthusiasm. I also thank the Editor of this journal for arranging this discussion and for giving me the opportunity to reply. Both Dr. Parrott and Dr. Allison-Bolger are concerned about whether my account is fundamentally tenable. They suggest that I (...) make two incompatible claims in the paper: I deny that a schizophrenic thinker suffering from thought insertion has the appropriate dispositions to enter the cause/reason-giving practice for the thought that she... (shrink)

This study in comparative phenomenology offers a description of the lived-world of the Stimmung, an experience especially characteristic of early stages of schizophrenia. In this state, the patient will stare transfixed at an alienated perceptual world that may have one or more of several anomalous characteristics. The world may seem strangely unreal; objects may seem fragmented, or devoid of standard pragmatic meanings and manifesting instead their sheer existence; or objects and events may seem imbued with a tantalizing but ineffable quality (...) of significance. Like many schizophreniform symptoms, the Stimmung has often been considered to be radically alien, beyond the pale of an empathic comprehension. The nature of these symptoms and their role in the overall development of schizophreniform illnesses is discussed, largely through examining the experiences of “Renee,” author of the Autobiography of a Schizophrenic Girl. Certain closely analogous phenomena from the culture of early modernism are then considered— focussing primarily on works by Hugo von Hoffmansthal, a turn-of-the-century Austrian writer. The possibility of a detailed phenomenological description, as well as the existence of such close modernist parallels, would seem to contradict the widely held view that such symptoms are incomprehensible. (shrink)

This paper is a preliminary inquiry into the nature of implication; how things are seen as ‘going together’ or following one from another. The argument presented here is that implication is non-logical and is central to the routine process of reason, induction and generalization. The organizing force underlying implication and practical inference is argued to be Von Domarus’ Principle , by which similarity on some dimension of interest ‘carries over’ to some other dimension of interest.One major difficulty with this formulation (...) is that where VDP is the only organizing force, incoherent utterances resembling the word salad of the schizophrenic are likely to result, quite a departure from the routine utterances of normals that a useful model should generate. Two important ways that normal speech and word salad differ are that, in the latter, associations are, first, often implausible or bizarre, and second, they are likely to be so personalistic as to be virtually inaccessible to others.These considerations led to a search for elements that would provide the corrections necessary to bring the products of a VDP based model of implication close to normal utterances in these two areas. One element that appears central, concerns the role of subjective probability in evaluating plausibility of associations. Also considered are aspects of ambiguities in ordinary language especially concerning number and probability. The problem of making associations accessible to others is mitigated by providing elements in the setting or the communication itself that act to highlight or salience the association intended to be communicated. Finally, suggestions for further research are presented. (shrink)

1. Built upon systems of nosology that claimed to be “atheoretical,” modern psychiatry largely relies on descriptive psychopathological models based on the assumption that psychotic symptoms (such...

Both scientific evidence and folklore have suggested that madness is associated with creativity, especially in the arts. Recently, more rigorous studies have confirmed to some extent these previous observations. The current view is that it is not severe and acute insanity that is related to heightened creativity, but the personality roots and soft manifestations of both schizophrenic and bipolar psychoses. The affective and cognitive peculiarities associated with schizotypic and hypomanic personalities may be preferentially related to different kinds of creative endeavours, (...) such as the sciences and arts, respectively. The connection between personality traits and creativity is produced because they share some biological-cognitive-personality features, such as cognitive disinhibition. Additionally, it has been shown that the genetic liability for both bipolar and schizophrenic psychoses is related to creativity. A prevailing hypothesis is that creativity may be one type of 'compensatory advantage' for those carrying the genes for psychosis. (shrink)

Patients with delusions of control are abnormally aware of the sensory consequences of their actions and have difficulty with on-line corrections of movement. As a result they do not feel in control of their movements. At the same time they are strongly aware of the action being intentional. This leads them to believe that their actions are being controlled by an external agent. In contrast, the normal mark of the self in action is that we have very little experience of (...) it. Most of the time we are not aware of the sensory consequences of our actions or of the various subtle corrections that we make during the course of goal-directed actions. We know that we are agents and that we are successfully causing the world to change. But as actors we move through the world like shadows glimpsed only occasional from the corner of an eye. (shrink)

Philosophy has a schizophrenic relationship with games. On the one hand, philosophers love using games as model, arguing that phenomena as diverse as linguistic meaning, meta‐ethics, normative ethics, applied ethics, law, and aesthetics can be illuminated via an analogy with games. On the other hand, there is scant focused discussion of the concept of a game as such. This is problematic; the appeal to games as a model to clarify philosophically puzzling questions has limited utility if games themselves (and the (...) concept of a game) are poorly understood. Moreover, playing games plausibly is an important element in a good life; anyone interested in the theory of welfare, a traditional philosophical topic, should be interested in games. We play games, but if anything, play itself has been more neglected by philosophers than games. This neglect is unwarranted. Historically, philosophy has investigated foundational questions about human nature, and a disposition to play plausibly is a deep part of human nature. Moreover, play is an important concept in evolutionary biology and psychology, yet those working in those fields struggle to define the concept to their own satisfaction. E.O. Wilson went so far as to remark that “no behavioural concept has proved more ill‐defined, elusive, controversial, and even unfashionable than play.” One might have hoped philosophers could help here. In this paper, I provide an opinionated introduction to the philosophy of play and games. (shrink)

Sense of agency is a compelling but fragile experience that is augmented or attenuated by internal signals and by external cues. A disruption in SoA may characterise individual symptoms of mental illness such as delusions of control. Indeed, it has been argued that generic SoA disturbances may lie at the heart of delusions and hallucinations that characterise schizophrenia. A clearer understanding of how sensorimotor, perceptual and environmental cues complement, or compete with, each other in engendering SoA may prove valuable in (...) deepening our understanding the agency disruptions that characterise certain focal neurological disorders and mental illnesses. Here we examine the integration of SoA cues in health and illness, describing a simple framework of this integration based on Bayesian principles. We extend this to consider how alterations in cue integration may lead to aberrant experiences of agency. (shrink)

Phenomenology represents a mainstream in the philosophy of subjectivity as well as a rich tradition of inquiry in psychiatry. The conceptual and empirical study of language has become increasingly relevant for psychiatric research and practice. Schizophrenia is still the most enigmatic and most relevant mental disorder. This volume represents an attempt to bring specialists from different fields together in order to integrate various conceptual and empirical approaches for the benefit of schizophrenic research. We hope that it will facilitate discussions among (...) members of such diverse fields as psychiatry, psychology, and philosophy. (shrink)

The experience of conscious will is the feeling that we are doing things. This feeling occurs for many things we do, conveying to us again and again the sense that we consciously cause our actions. But the feeling may not be a true reading of what is happening in our minds, brains, and bodies as our actions are produced. The feeling of conscious will can be fooled. This happens in clinical disorders such as alien hand syndrome, dissociative identity disorder, and (...) schizophrenic auditory hallucinations. And in people without disorders, phenomena such as hypnosis, automatic writing, Ouija board spelling, water dowsing, facilitated communication, speaking in tongues, spirit possession, and trance channeling also illustrate anomalies of will – cases when actions occur without will or will occurs without action. This book brings these cases together with research evidence from laboratories in psychology to explore a theory of apparent mental causation. According to this theory, when a thought appears in consciousness just prior to an action, is consistent with the action, and appears exclusive of salient alternative causes of the action, we experience conscious will and ascribe authorship to ourselves for the action. Experiences of conscious will thus arise from processes whereby the mind interprets itself – not from processes whereby mind creates action. Conscious will, in this view, is an indication that we think we have caused an action, not a revelation of the causal sequence by which the action was produced. Key Words: apparent mental causation; automatism; conscious will; determinism; free will; perceived control. (shrink)

Extant philosophical accounts of schizophrenic alien thought neglect three clinically signifi cant features of the phenomenon. First, not only thoughts, but also impulses and feelings, are experienced as alien. Second, only a select array of thoughts, impulses, and feelings are experienced as alien. Th ird, empathy with experiences of alienation is possible. I provide an account of disownership that does justice to these features by drawing on recent work on delusions and selfknowledge. Th e key idea is that disownership occurs (...) when there is a failure of rational control over one’s mind. Th is produces a clash between the deliverances of introspection and practical enquiry as ways of knowing one’s mind. Th is explanation places disownership on a continuum with more common aspects of our psychological life, such as addiction, akrasia, obsessional thinking, and immoral, selfi sh or shameful thoughts. I conclude by addressing objections, and exploring the relevance of my account to questions in the philosophy of psychiatry concerning the validity of our current taxonomy of symptoms, and the nature of psychiatric classifi cation.. (shrink)

This article examines the supposedly incomprehensibility of schizophrenic delusions. According to the contemporary classificatory systems (DSM-IV-TR and ICD-10), some delusions typically found in schizophrenia are considered bizarre and incomprehensible. The aim of this article is to discuss the notion of understanding that deems these delusions incomprehensible and to see if it is possible to comprehend these delusions if we apply another notion of understanding. First, I discuss the contemporary schizophrenia definitions and their inherent problems, and I argue that the notion (...) of incomprehensibility in these definitions rests heavily on Jaspers’ notions of understanding and empathy. Secondly, I discuss two Wittgensteinian attempts to comprehend bizarre delusions: (a) Campbell’s proposal to conceive delusions as framework propositions and (b) Sass’s suggestion to interpret delusions in the light of solipsism. Finally, I discuss the phenomenological conception of schizophrenia, which conceives delusion formation as resulting from alterations of the structure of experiencing and from underlying self-disorders. I argue that although a psychological understanding that seeks to grasp meaning in terms of motivations, desires, and other more straightforward psychological connections between mental states is impossible in schizophrenia, we can in fact have a philosophical understanding of the schizophrenic world and of the emergence of delusions typically found in schizophrenia. (shrink)

The distinction of „understanding“ and „explaining“, formulated by Karl Jaspers in his „General Psychopathology“, has had a lasting effect on psychiatry. As a result, phenomenological, hermeneutic, or psychodynamic approaches have often been accorded only descriptive or epiphenomenal status, while the actual causes of mental illness have been sought in neurobiologically or genetically based explanations. In contrast, this paper defends the explanatory role of understanding and phenomenological approaches. To this end, two levels of explanation are distinguished and shown to be equally (...) justified in principle, namely, motivational explanation at the macro-level and physical explanation at the micro-level. The actual causal role of motivational, i.e., understandable connections is then demonstrated by means of a conception of circular causality, which includes downward causality. Finally, the explanatory role of phenomenological analyses is also shown in psychotic disorders that refuse motivational understanding, using the example of schizophrenic delusion. (shrink)

According to Jaspers, claims to the effect that one's thoughts, impulses, or actions are controlled by others belong to those schizophrenic symptoms that are not susceptible to any psychological explanation. In opposition to Jaspers, it has recently been suggested that such claims can be made intelligible by distinguishing two ingredients in our common sense notion of ownership of a thought: It is one thing for a thought to occur in my stream of consciousness; it is another for it to be (...) interpretable in terms of my propositional attitudes. I argue that this distinction cannot be sustained and pursue an alternative suggestion, drawing on Louis Sass's "solipsist interpretation" of schizophrenia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 327-329 [Access article in PDF] Husserlian Comments on Blankenburg's "Psychopathology of Common Sense" Osborne P. Wiggins, Michael Alan Schwartz, and Jean Naudin In this essay, Wolfgang Blankenburg sketches his influential view that some of the disturbances of schizophrenia in particular can be interpreted as a pathology of common sense. We think it important at the outset, however, to avoid possible misunderstandings of (...) Blankenburg's point. It is perhaps unfortunate that this point is expressed by use of the phrase, "common sense." As Blankenburg's own essay shows, even among the learned, "common sense" has no definite or univocal meaning. Therefore, it is entirely possible to find many people who, under some conception of "common sense," appear to lack common sense and yet should not be deemed schizophrenic. Consequently, it is probably best to avoid the ambiguous phrase "common sense" altogether and seek to comprehend Blankenburg's point in other terms. That is precisely what we shall attempt here. We do endorse Blankenburg's view. Moreover, we shall pursue his suggestions that a Husserlian phenomenology of our experience of the life-world may provide the basis for developing the kind of psychopathology he seeks. Our ultimate aim, however, is for this phrase "common sense" to vanish into the Husserlian phenomenology we offer, so that all the other meanings of common sense will not threaten Blankenburg's position with misunderstandings.Our comments must remain a mere sketch. Since, however, Husserl's phenomenology is not well known, we shall have to devote some time to outlining those features of it that we deem relevant here.For Husserl, every mental process is an awareness of something. In his terminology, it is "intentional." No mental process occurs in isolation, however. It rather occurs within a concatenation of many other mental processes. Some of these co-occurring mental processes intend the same object; they intend other aspects of the object. For example, a woman may be aware of the color of a dress she is considering wearing. Hence, one process in her mental life is (visually) aware of the brown color. But another process in her mental life may be intending it as a "party dress." And yet another process in her mental life may be (tactually) intending the texture of the cloth. Because all of these mental processes (and many others) intend the same object, namely, the dress, Husserl says that they are synthesized with one another. "Synthesis," then, connotes a multiplicity of mental processes united with one another through intending the same object.Now Husserl believed that it is because the many processes occurring in our mental lives [End Page 327] synthetically intend the many objects we encounter that we experience ourselves as inhabiting a world of objects. If these syntheses failed to occur, we would not experience the world or ourselves as parts of this world. These syntheses make it possible for us to experience objects and events as related to one another in the manifold spatial, causal, temporal, social, political, religious, and other relationships that we do in fact experience. Husserl thus contends that our mental lives "constitute" the world for us. Mental life can accordingly be viewed as "world-constituting." Mental life is thus the condition for the possibility of there being a world of objects for us, to modify Kant's phrase. Husserl thought his notion of world-constituting consciousness sufficiently similar to Kant's for him to appropriate the latter philosopher's concept of "transcendental." Husserl also then spoke of "transcendental consciousness" and the study of this consciousness as "transcendental philosophy."Husserl made many distinctions among kinds of mental processes and their correlative objects. We shall here explicate only one such distinction. Mental processes must be distinguished as those that are actively generated by an ego and those that are not produced by an ego. The latter kind of mental process occurs automatically or, as Husserl writes, "passively." Husserl calls the first kind of mental process "active." Having mentioned him, however, we should also briefly characterize the "ego... (shrink)

The notion of minimal, basic, pre-reflective or core self is currently debated in the philosophy of mind, cognitive sciences and developmental psychology. However, it is not clear which experiential features such a self is believed to possess. Studying the schizophrenic experience may help exploring the following aspects of the minimal self: the notion of perspective and first person perspective, the ‘mineness’ of the phenomenal field, the questions of transparency, embodiment of point of view, and the issues of agency and (...) ownership, considered as different and less fundamental than the feeling of mineness. Two clinical vignettes of patients with the diagnosis of schizophrenia will be presented: the first one, illustrating early illness stages, and the second case, of chronic schizophrenia, symptomatically marked by persistent hallucinations. Through their analysis, we will discuss the experiential dimensions of minimal self. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:“Though This Be Madness, Yet There Is Method in ’T”A Positive Account of MadnessValentina Cardella, PhD (bio)What does it mean to be mad? How can we define mental disorder? The question is still widely discussed among psychiatrists and philosophers, and what exactly distinguishes sanity and insanity remains unclear. Despite this lack of clarity, the common conceptualization of madness is that mental disorders are impairments in rationality: people with mental (...) disorders are generally believed to have impairments in reasoning and logic (Bermúdez, 2001; Edwards, 1981; Harvey, Watkins, Mansell, & Shafran, 2004).Yet, the result of this conception is that we fail to understand madness. We do not understand how, for example, schizophrenic patients can be more logical than healthy people in some reasoning tasks (Mellet et al., 2006; Owen, Cutting, & David, 2007), or delusional patients can be perfectly rational in defending their ideas (Cardella, 2020), or depressive people can be more realistic than non-clinical subjects (Moore & Fresco, 2012). In contrast, if we consider rationality as the core feature of sanity, we fail to understand sanity, too, because normal people exhibit many kinds of biases and heuristics, and thus irrationality is widespread in the general population (Bortolotti, 2020; Johnson-Laird, 2006; Evans, 2002; Kahneman, Tversky, & Slovic, 1982).In his paper, Garson focuses on Late Modern theorists of madness (Locke, Kant, Wigan, and Heinroth) to reframe the problem and provide a positive account of mental disorder. These authors contrast madness to idiocy, rather than sanity, and therefore their conception of madness is very different: “while idiocy is marked by the diminished, or even abolished, functioning of the reasoning power, madness is marked by its perverse functioning. The mad person “has” reason, but deploys it in a perverse, improper, or unseemly manner” (Garson, 2023, p. 286).In his reading of Late Modern authors, Garson provides a new ontology of mental disorder, that goes beyond an absence of reason, and has also political and social implications. Furthermore, he reminds us that every scientific discipline has its philosophical assumptions. In defining madness, [End Page 305] we cannot help but choose a contrasting class, and each choice will have very different consequences. Even if psychiatry is a medical discipline, which aims to endorse a neutral view of mental disorder, it is impossible for it to be unbiased and impartial. All the more so, for it has to deal with human suffering and fragility.But, in this article, there is one crucial question that remains unanswered. In his analysis of Late Modern theorization of madness, Garson comes to the conclusion that madness is marked by a perverse deployment of reason. Yet, who decides when reason is deployed in a perverse manner? While the lack of rationality is something that we can detect easily enough, the task of defining precisely what is an ‘improper’ or ‘perverse’ use of reason is much harder. In other words, it seems to me that, in replacing the ‘lack of rationality’ paradigm with ‘the perverse rationality paradigm,’ the question of what is madness still remains open, and, most important, some normative aspects remain necessary. To recognize when rationality is improperly used, we have to adopt an evaluative stance, which defines what a proper use of reason would be.Valentina [email protected] University of MessinaValentina Cardella Valentina Cardella is Associate Professor of Philosophy of Language at the University of Messina, Italy. Her research interests encompass cognitive sciences, philosophy of language, and psychopathology.The author reports no conflicts of interest.Commentary submitted on June 13, 2023Accepted on June 13, 2023ReferencesBermúdez, J. L. (2001). Normativity and rationality in delusional psychiatric disorders. Mind and Language 16, 457–93. Google ScholarBortolotti, L. (2020). The epistemic innocence of irrational beliefs. Oxford: Oxford University Press. Google ScholarCardella, V. (2020). Rationality in mental disorders: too little or too much? European Journal of Analytic Philosophy 16 (2), 13–36. Google ScholarEdwards, R. B. (1997). Mental health as rational autonomy. In Edwards, R. B. (ed.), Ethics of psychiatry: Insanity, rational autonomy, and mental health care. New York: Prometheus Books. Google ScholarEvans, J. (2002). Logic and human reasoning: an assessment of the deduction paradigm. Psychological Bulletin 128... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 339-341 [Access article in PDF] Schizophrenia and Self-Awareness Dan Zahavi In his paper, "Cogito and I: A Bio-Logical Approach," Kimura Bin raises a number of intriguing issues. Let me in the following address a few of them. Kimura Bin's point of departure is the idea that schizophrenia is basically to be understood as a disorder of self and self-experience. Thus, fundamental alterations (...) in the sense of possession and control of one's own thoughts, actions, sensations, or emotions figure among the most prominent symptoms in its advanced stages. But even in the absence of overt symptoms, the schizophrenic may feel uncertain about her selfhood, and it is often in an attempt to restore or at least sustain her precarious self-identity that the patient engages in characteristic obsessive self-reflections that frequently simply exacerbate the problem.1. One way to illustrate what is peculiar about the self-disorder in schizophrenia is by contrasting it with the symptoms found in senile dementia. Whereas the demented patient might lack any knowledge about the features that characterize him from a third-person perspective, i.e., age, nationality, profession, location, etc., he is usually in possession of an intact first-person perspective: He is still aware of the I-Here-Now. In schizophrenia, the problem is typically exactly the reverse (Tatossian 1997, 26). This contrast makes it tempting to argue, as Kimura Bin in fact does, that we need to distinguish two different dimensions of selfhood: the self as subject and the self as object. Of course, by making that distinction, we are immediately partaking in a classical philosophical discussion. Thus, at least since Kant, it has been customary to distinguish between the transcendental subject and the empirical or mundane subject. This distinction can be cashed out as a distinction between two different ways of being aware of oneself, one external, the other internal. On the one hand, I can think of myself from a third-person perspective, that is, I can refer to an object by way of a proper name, a demonstrative, or a definite description, and occasionally this object happens to be myself. When I refer to myself in this way, I am referring to myself in exactly the same way that I can refer to Others, and Others can refer to me (the only difference being that I am the one doing it, thus making the reference into a kind of self-reference). Apart from being external and contingent, this kind of self-reference is also non-thematic, since it can occur without my knowledge of it, that is, I can refer to myself from the third-person perspective without realizing that I myself am the referent. In contrast, the self-reference available from the first-person perspective—the one expressed in the subject-use of "I"—is of an internal kind. Not only is it impossible to refer to anybody and anything apart from oneself in the first-person way, but it also belongs to the proper use of "I" that one knows that one is referring to oneself. That is, apart from being internal and necessary, the self-reference in question is also of a thematic nature. In [End Page 339] more traditional terms: One can be conscious of oneself as an empirical object with mental properties, and one can be conscious of oneself as the subject of intentionality. Or again, one can be aware of oneself as a causally determined known object, as a part of the world, and one can be aware of oneself as a knowing subject, as—to paraphrase Wittgenstein—the limit of the world. In short, the difference between the empirical subject and the transcendental subject is closely linked to the difference between being aware of oneself as an object in the world and being aware of oneself as a subject for the world.Utilizing this distinction, it can be said that schizophrenia involves a disturbance on the transcendental level (this way of speaking would, by the way, be anathema to a classical Kantian transcendental philosophy but more acceptable to the... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Anthropological Perspectives in Psychiatric NosologyJuan J. López-Ibor Jr. (bio) and María-Inés López-Ibor (bio)KeywordsDSM, etiology, Aristotelian causes, social dramasPsychiatry and clinical psychology, as we learn in this paper, are disciplines in need of an ontological perspective. Very few branches of contemporary learning share this characteristic. Probably only theoretical physic and theology—as the rest have long ago given up trying to define and understand the essence of their object, for (...) example, life in the case of biology or mind in psychology. Consequently, the paper by Pérez-Álvarez, Sass and García-Montes, “The Ontology of Mental Disorders in Constructivist Perspective,” (2008) should be welcomed and indeed included in the reading lists for trainees in psychiatry and clinical psychology.The authors propose an approach to the understanding of mental disorders that is extremely attractive and well articulated, and which also has practical implications for clinicians. It is not just another “philosophical divertimento” devoid of scientific and practical importance. Let us analyze the article in an orderly way.Less DsmThe authors of the target paper disapprove of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III/IV approach to defining illnesses by starting from the symptoms that are present—on the grounds that this may lead clinicians to assume that their sole role is to identify, fight, and suppress the symptoms by whichever procedure. They propose an alternative that is dear to myself because it follows the path of the so-called “anthropological” psychiatry of Binswanger, von Gebsattel, Erwin Strauss, Zutt, López-Ibor, Sr., and others. In essence, this is a phenomenological approach to the meaning of mental diseases, one that emphasizes how the illness is revealed to the patient him- or herself.The target article’s criticism of DSM should be considered in the context of the abuses committed on its behalf. The DSM is not a textbook of psychiatric disorders, nor does it contain a definition of the diseases. The DSM does not tell what a disease is (Klerman et al. 1984)—something that is impossible with a classification system based on the manifestations of the diseases, the signs and symptoms. The DSM, as its title states, is just a diagnostic and statistical manual, which does not contain anything about the origin of [End Page 259] any disease nor an explanation of why it exists or what it means. The DSM is, in fact, just a tool to determine whether a disease is present, and therefore to facilitate communication between professionals and with other individuals, without saying anything about the disease’s aitia—a key term (associated with notions of essence as well as cause) to be discussed below. In theory, most clinicians should understand these limitations; it may be, however, that this is not really the case for many who read or use the DSM. In the world there are around 200,000 psychiatrists; since 1980 the number of DSM copies sold is in the order of several hundred thousand.The misuse of a classification system is even more noticeable in the International Classification of Diseases (ICD)-10 Research Version. The instructions for the use of this version recommend that the first step is to make an inventory of all the symptoms present, and then to construct a diagnosis based on them. This how all computer-assisted systems work. This procedure can, however, only be valid if the clinician has already reached a diagnostic conclusion by other means—a diagnosis then to be confirmed for research purposes. It may be that this is one of the reasons why the ICD-10 Research Version has almost never actually been used for research.Furthermore, the concept of symptoms in psychiatry applies only to organic mental disorders (Schneider 1959), conditions in which the patient’s attitude and way of experiencing the symptoms do not play the kind of role that they play in schizophrenia and other mental disorders. The quotation from the important paper by Sass and Parnas in this context is most appropriate. It is indeed that case that “subjective experience can play an important causal role in the progressive experiential transformations of a developing schizophrenic illness... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 295-298 [Access article in PDF] A Dialectical Conception of Autism Giovanni Stanghellini Some Reasons for the Philosophical Turn in the Psychopathology of Schizophrenia There are many ways to become a schizphrenic. Each individual has her own schizophrenia, coherent with her life history, her problems and alternatives deriving from them (Binswanger 1960). What clinical psychiatry calls "schizophrenia" is not a unitary illness but (...) a common final state—a "syndrome" in the etymological sense, that is, a condition to which different psychopathological pathways may lead. Schizophrenic symptoms, like Schneiderian first-rank symptoms (delusions, hallucinations, experiences of passivity), are nothing but a rather uniform type of reaction. First-rank Schneiderian symptoms may be interpreted as attempts to explain disturbing basic experiences of change in self, body, and world perception (Klosterkoetter 1988) or as the epiphenomena of complex interactions between sensory disorders (aberrations in the perception of self, body, and world), conceptualisation disorders (impairments in the constitution of meanings and intentions), and attitudinal disorders (eccentric structure of values and beliefs) (Stanghellini 2000a). Since the schizophrenic syndrome, as defined by current diagnostic manuals, lacks any authentic core phenomena, and so-called schizophrenic symptoms are not specific (Berner and Kufferle 1982), the clinical diagnosis of schizophrenia finally becomes a diagnosis by exclusion (Maj 1998). This conceptual weakness is obviously unacceptable (not only for old dissenters from operational diagnostic criteria) and is kindling a velvet revolution in nosological studies and a renaissance of philosophically oriented psychopathological research (Parnas and Zahavi 2000). Autism: The Loss of Vital Contact with Reality Eugène Minkowski was a forerunner in the field of philosophical psychopathology: "The psychiatrist and the metaphysician become one in their common research concerning what is human and human experience" (Minkowski 1947). Indeed, his doctoral thesis on autism (Minkowski 1926) was dedicated to his teachers, the psychiatrist E. Bleuler and the philosopher H. Bergson, and his conceptualisation of autism is an ideal example of the link between philosophical perspectives and psychopathological research. The term "autism" was introduced by Bleuler (1911) to describe detachment from outer reality and immersion in inner life. Bleuler's concept of autism relied on Freud's (1905) notion of autoerotism and on associationistic psychology. According to Bleuler, autism was a consequence of the [End Page 295] splitting of psychic functions: a defense mechanism serving to avoid conflicts between desires and reality testing, promoting the shift to inner fantasy life and entailing social withdrawal, emotional indifference, inappropriate behaviors, and idiosyncratic values and beliefs.Minkowski, who was influenced by Bergson and phenomenology, departed from Bleuler's conceptualisation and defined autism as "loss of vital contact with reality" (Minkowski 1926, 1927). For Minkowski, autism is not a symptom, but a global phenomenon investing the whole person. Autism is a way of being whose essential feature is a pragmatic deficit: Autistic activity consists in the reduced capacity to interact with the external world. Autistic thought is characterized by its lack of communicative action. The pragmatic deviance of autistic language is a good example: The autistic person is not interested in communicating her inner world to the others; language is not a means of communication which serves mutual understanding, a cooperative process whose aim is interlacing one's own world with that of others. The autistic person's use of language is much like a soliloquy, the monologue of the solitary thinker more focused on ex-pression—the outward portrayal of immanent contents of consciousness—than on dialogue—the exchange of meanings between speaker and listener. Moreover, each meaning is presented in its manifold profiles or adumbrations and the task of selecting the context-relevant meaning is left to the listener.The pragmatic weakening of the autistic person, according to Minkowski, is not simply a social or occupational dysfunction (APA 1994), that is, a renunciation or refusal to act according to social expectations and standards. It involves the loss of vital contact with reality. The meaning Minkowski attributes to the term "vital" is essential for understanding his philosophical approach to defining the schizophrenic condition. Minkowski assumes that contact with reality is vital when it is established through action (and language... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophers, Carers, and Psychodramatic GamesCorinne Gal (bio), Alexandre Chapy (bio), Marielle Fau (bio), and Muriel Guaveia (bio)Dear Jonathan D. Moreno,Thank you for the honor of taking the time to comment on the work we do. It is very meaningful for us to be able to talk with you.We, too, see a big difference between philosophers and carers (in the broadest sense) who deal with the suffering of patients and (...) try to find methods to help them. But, if theory is at the service of the clinic, it becomes a formidable asset to refine our therapeutic methods and better understand what is happening to our patients.Indeed, patients suffering from psychosis, severe neurosis … are difficult to accompany and “recalcitrant to therapy by word alone” to use your terms. It is on this point that Ludwig Binswanger distanced himself from psychoanalysis. Binswanger ran a sanatorium in Switzerland (the Bellevue Clinic) and took in patients suffering from this type of psychological pathology. Aware that “the divan” and the analysis of the transference (unconscious) made little progress, he sought other ways of understanding his patients. The work of Edmund Husserl, the founder of the phenomenological movement, and then the work of Martin Heidegger1 fascinated him because they attempted to answer fundamental questions about being. The patients we work with ask themselves and us the same question: What is being? How can we feel existence within ourselves? Binswanger then created daseinsanalysis as an analysis of existence in which he was able to develop, among other dimensions, what he called “artists’ gestures,” including the possibility of (physical) contact with the patients. The body regained existential importance in the therapy.There are also strong similarities between psychiatric phenomenology and the work of Jacob Levy Moreno (2014, p. 214). We would like to quote your work: “ Nonetheless, there were links between them. Heidegger and J.L. shared preoccupation with personal authenticity and meaning [End Page 230] just enough to be considered part of the trends that led to postwar existentialism and fueled the new humanistic psychology, NTL, and encounter groups.”Jacob Levy Moreno’s working methods are much more powerful, allowing us to work as closely as possible with bodily feelings, since the body involved in the action is so present in psychodrama. Because, to this question of being posed by our patients, is linked the body as a felt, sensing body: the body that I am (which differs from the object body). Schizophrenic patients often express, and this is a terrible suffering, that they no longer feel anything, that they no longer feel they exist, that they no longer feel emotions or feelings. They do not know how to be in the world and with others. For us it is a fundamental symptom, as much as hallucinations. We link it to the loss of natural evidence (Blankenburg, 1991), the loss of contact with reality (Minkowski, 1929). Most of the time, in psychodrama, we “externalize” what the patients feel in different roles played by players, which allows us to work at the heart of each person’s difficulties in interaction. Trained in psychodrama by Anne Ancelin Schützenberger, we have to our credit a set of techniques to support the expression of psychodramatic play, a sort of “toolbox.” Depending on the context, the moment of the patient, our own state, we open our toolbox and try to choose and use the technique that best fits the needs of the game, of what we understand about the difficulty of the protagonist or the group. We do not do anything systematic, we are craftsmen. We have chosen to present a very simple game, without any technique used, except for the initial soliloquy, with a stabilized patient suffering from paucisymptomatic forms of schizophrenia. This is to demonstrate how the possibility of encounter, constitutive of existence, is a fundamental dimension of psychodrama.We thank you for the examples you have given us, they will be a source of inspiration and will fill our toolbox.To John Nolte:We thank you very much for your comments which honor us.The aim of the article was to present how the encounter in... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.1 (2004) 35-41 [Access article in PDF] The Rationality of Psychosis and Understanding the Deluded Matthew R. Broome Campbell's important and influential paper (Campbell 2001) has framed the debate that Bayne and Pacherie (2004) most explicitly, and Klee (2004) and Georgaca (2004) more implicitly, engage in. Campbell has offered two broad ways of thinking about explanations of delusions—the empirical and the rational. He offers (...) some criticism of the former and an endorsement of the latter. Campbell uses examples from clinical psychopathology to illustrate his argument and Bayne and Pacherie in turn employ these. Campbell discusses the eponymously named delusions of Capgras and Cotard—the former a subtype of delusional misidentification and the latter a delusion whose content is colored predominantly with nihilistic and possibly hypochondriacal themes. Campbell, Bayne and Pacherie, and Klee discuss the empirical data in relation to such delusions and as an aid to discussing the empirical model more generally. It does seem a little unfortunate that these delusions, which are less than typical, become the focus of Campbell's paper, and Bayne and Pacherie's criticism of his work. Delusions are remarkably heterogeneous; this indeed may be part of the reason why there is so much difficulty in reaching a definition as Klee discusses, and occur in a wide variety of mental and neurological illnesses. The most common delusions are those of persecution and reference (World Health Organization [WHO] 1973) and typically occur in schizophrenia. By contrast, delusional misidentification occurs most commonly in patients with dementia, delirium, and focal cognitive impairment, but can occur in other functional psychoses such as an affective or schizophrenic psychosis. The most common form of delusional misidentification is not that of either the exotic Capgras or Fregoli syndromes but delusional misidentification for place; thus, although Bayne and Pacherie's arguments against Campbell may still hold, delusional misidentification tends to occur in the context of a patient believing that they are at home or on holiday rather than in hospital and may not necessarily involve close family members or other intimate relationships. Similarly, Cotard's syndrome tends to occur in the context of a severe depressive illness with mood-congruent psychotic symptoms, typically in an elderly individual. It does not have to have the content that the deluded is dead, but can include beliefs, for example, that the world no longer exists or that their internal organs are not present. Thus, a patient with either Capgras' or Cotard's syndrome is likely to differ from patients with delusions of persecution. They would [End Page 35] have different diagnoses, probably be older, and have a greater likelihood of structural abnormalities of the brain on imaging and consequent neuropsychological dysfunction. That is not to say that patients with schizophrenia have normal cerebral anatomy and neuropsychology, but rather that the Capgras' and Cotard's patients are likely to have neurological quality to their presentation that is clinically relevant, rather than what commonly the case in schizophrenia and the other functional psychoses, where the neurological abnormalities are only currently important at the level of academic research. Empirical Models of Delusion Formation Different delusions may not have that much in common, nor may the patients who believe in them. This in turn relates to the empirical paradigm that both Campbell and Bayne and Pacherie discuss. It is true that current research, and indeed the clinical practice of cognitive behavioral therapy for psychosis, is indebted to the work of Maher and it is within his legacy which we work. This, however, is not to say that we think his initial formulation was correct. Maher's (1988, 1992) work focused attempts in explaining delusions—both to support and refute his thesis that delusions are the consequence of normal cognitive mechanisms seeking to explain an anomalous sensory experience. Such a view initially led to work demonstrating delusions in the absence of anomalous perceptions, the presence of reasoning biases in the deluded population, and the possibility that abnormal sensory experience may be consequent upon biased cognitive processes (Garety and Freeman 1999). More recent work has demonstrated the prevalence of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 343-346 [Access article in PDF] Kimura Bin on Schizophrenia James Phillips With "Cogito and I: A Bio-Logical Approach," Kimura has continued his research into the core disturbance in schizophrenia. In his work, he has combined an original phenomenological approach with some fundamental concepts taken from his native Japanese and Zen culture. As in the work of others in the tradition of phenomenological (...) psychiatry, he has focused on a basic disturbance that underlies the positive symptoms found in schizophrenic conditions. In what follows, I will attempt to relate this current effort to some of his previous work on schizophrenia. I will conclude this commentary with some remarks on what I find problematic in the treatment of Heidegger.In "Cogito and I," Kimura plunges us directly into the core ego disturbance of schizophrenic patients by quoting two patients who, each in his own words, describe a pathological split between what we may call a "subjective" and an "objective" I or self. The latter is the self that acts and is recognizable by others (and by the patient) as the agent acting in the world. The former, the subjective self, is the non-objectified sense of self or self-awareness that accompanies all our actions. The two must be integrated, and it is a failure of this integration that is at the basis of the schizophrenic's ego disturbance.We can gain further clarification of this central notion in Kimura's treatment of schizophrenia through reference to some of his other discussions of the topic. In "Reflection and Self in the Schizophrenic" (Kimura 1992b), he invokes Husserlian terminology to discuss the same polarity within the self. 1 In this study, he distinguishes "simultaneous reflection" (the subjective self) from "secondary reflection" (the objective self). In the latter, the self is a noematic object of reflection; it is the image of myself after the act, the I that has done something and can now be captured in reflection. While "Cogito and I" describes the schizophrenic split as between the noematic self and the noetic self of simultaneous reflection, "Reflection and Self in the Schizophrenic" locates the split further back within the noetic self. Kimura distinguishes in the noetic self an observing I from the I that is moving toward action, both prior to the noematic self of secondary reflection. "One could say that a subjective self here accompanies an other self no less subjective and observes it constantly 'from behind'. There is no objective, noematic self involved here; a sole noetic self splits into two simultaneous 'moments' which occupy alternitively the places of seeing and seen, and which nonetheless remain subjective-noetic" (Kimura 1992b, 118). Pélicier emphasizes this Husserlian analysis in his exposition of Kimura Bin's phenomenological treatment of schizophrenia: The Self is never grasped as an object, but rather experienced in a noetic mode. On the other hand, the representation (l'image), as an object of consciousness, and in a certain manner all representations (images), as objects of consciousness, are of the noematic [End Page 343] order in Husserl's sense. Kimura insists then on the difference between this auto-perception (jikaku) in the noetic register and its content, which, itself, is noematic. Starting from this analysis, Kimura poses to himself the question of the nature of schizophrenia.... (Pélicier 1984, 32) In still another treatment of the theme, "Pathology of the Immediate" (Kimura 1992c), Kimura Bin focuses on the role of language in the structure of the self. The circuit of simultaneous and secondary reflection described above is played out in the pre-linguistic and linguistic dimensions of the self. Simultaneous reflection is immediate and fugitive in a manner that escapes articulation but at the same time, very readily flows into a secondary reflection that exists only as a mediated, articulated, noematic self. As Kimura puts it, "As for the I, which seems apparently the most immediately given, this also, when it becomes conscious of itself as 'I,' is constituted equally as an experience mediated by a negative differentiation that inserts itself between the 'I' that is in the process of becoming... (shrink)

This text reads into the work of Ibrahim Nubani (1962—), a Palestinian-Israeli painter who was diagnosed with schizophrenia in 1988, during the first Intifada. Nubani’s painting has undergone a tremendous change from the 1980s and the period of his hospitalization to his painting style today: from geometric, Modernist-type painting, gradually moving into his contemporary chaotic and saturated style of expression. I draw parallels between Nubani’s personal and psychological condition and the political events that affected him. I refer to his state (...) in relation to the discourse of mimicry and camouflage in nature, comparing his position to that of the invisible presences in the background in a perfect camouflage, referring to Roger Caillois’ interpretations. I look at his diagnosed psychiatric state of schizophrenia as the materialization of the meaning of being a Palestinian-Israeli in a life of fragmentation and rejection, by referring to Bhabha and Shammas. I relate to Deleuze and Guattari’s notions of schizophrenia as a cultural rebellion against the moderating mechanisms of cultural/national identification. I demonstrate how Nubani’s work and speech undermine the modalities of mainstream Israeli society, acting like a cultural insurgent, terrorizing Zionist axioms. While analysing Nubani’s iconography I identify several tropes, images and icons that serve as signifiers of his personal crisis and artistic development. I link Nubani’s eyes/ocelli images to Lacan’s discussion of ‘symbolic castration’ as the core of his personal becoming part of Israeli society and his collapse, the in-between desire to assimilate in the early stages of his life, and his current desire to fully live his life as a Palestinian. The text moves between his images and images from other sources that open Nubani’s world into the discourses of Western painting, schizophrenia, high Modernism, the postcolonial condition and so forth. The text is fragmented into eight pieces, following the schizophrenic break-up of Nubani’s personal state and his painted work. I read his work as a destabilizing agent, and identify visual references drawn from the wider context of art history, and specifically referring to masterpieces of the Israeli art canon. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 299-301 [Access article in PDF] Reading Minkowski with Husserl Bernard Pachoud Eugene Minkowski is generally regarded as one of the main figures of the phenomenological strand of psychiatry in France. However, it is striking that, as a phenomenologist, he very rarely mentions Husserl or Heidegger in his texts. Nor, for that matter, does he use their concepts or rely on their descriptions (...) (except in a few texts entirely devoted to the presentation of the philosophical roots of phenomenology). Actually, the philosopher he most often refers to, and whose concepts he borrows, is Bergson, who is not a phenomenologist. But although Minkowski's framework is not phenomenological in the philosophical sense of the term, his clinical descriptions are certainly based on a genuinely phenomenological approach—in the sense that they deal with the subjective experience of patients and the way in which their experience determines their behavior. It is all the more striking to notice just how much his descriptions of abnormal experiences echo certain Husserlian studies that he seems to ignore. I will focus on some common points between Minkowski's clinical descriptions and Husserlian studies that Minkowski could not, in fact, have known at the time of writing this article (at least in their complete form, since they were developed after 1923).The present text, "A Contribution to the Study of Autism: The Interrogative Attitude," is a typical example of Minkowski's clinical descriptions and theoretical interests. The interrogative attitude of the patient Paul C. is considered by Minkowski to be one of the "schizophrenic attitudes," expressing what he calls "loss of contact with reality," a phenomenon held to be characteristic of schizophrenia. These attitudes are quite simply the modalities of schizophrenic "autism" in Bleuler's sense of the latter term. Minkowski (1925) distinguishes the attitudes of withdrawal that have an affective coloring (morbid daydreaming, sulking, and regrets) from those that are purely intellectual (morbid rationalism, the interrogative attitude, the morbid hypertrophy of geometric and static factors). What gives a pathological cast to Paul C.'s systematically interrogative attitude is that it expresses (following Minkowski's clinical description) the patient's inability to engage in action or to establish any practical relationship with reality. This interrogative attitude can be considered a way to take some initiative and thereby avoid complete passivity, but it is a deficient mode of "position taking" since there is no engagement in real action.This emphasis on disorder of action has a modern sound, for it echoes theoretical hypotheses regarding schizophrenia developed by contemporary neuroscientists (Frith 1992). It also echoes the Husserlian studies of perception, in which the feeling of reality largely depends on the strong connection between perception and voluntary movement (action), kinesthetic sensations playing here a key role (Husserl 1989). There are also some remarkable convergences [End Page 299] with Husserl's studies of the active and passive dimensions of consciousness, to be considered next. Husserl's Studies of the Activity and Passivity of Consciousness The main claim of transcendental phenomenology is that our experience completely depends on what Husserl calls the synthetic activity of consciousness. Everything that we become aware of is constituted by the activity of the mind. In texts written between 1918 and 1926 and gathered together under the title, "Analysis of Passive Synthesis," Husserl (1966) distinguishes different degrees of the activity of consciousness, depending on whether or not the ego has the initiative. Mainly, two kinds of activity are described, one depending on the subject (the ego) and requiring his initiative, the other occurring, so to say, in an anonymous, automatic way, elicited by the object, and labeled for this reason "passive synthesis." In other words, when experience relies on synthetic activity, Husserl distinguishes synthetic acts initiated by the ego (the genuine acts) from those that occur in consciousness in an automatic, passive way. Accordingly, the activity of consciousness turns out never to be a pure activity; it always occurs against a background of passivity. Most often, the act is a response to prior stimulation given passively, and it is through this act that the "I" discovers itself as a... (shrink)

The title of this book is particularly significant in that Dr. Rushdoony was able to identify the basic contradiction that pervades a secular society that rejects God's sovereignty by still needs law and order, justice, science, and meaning to life. Secular man wants to use the thinks of creation while denying their creator. As Dr. Rushdoony writes, 'there is no law, no society, no justice, no structure, no design, no meaning apart from God.' And so, modern man has become schizophrenic. (...) He wants to assert his autonomy while rejecting the divine order that gives meaning to life. To the humanist, the aim of living is something he calls the 'good life.' For the nihilist, it is violence and death. Dr. Rushdoony saw cultural schizophrenia as a split between thought and feeling, a withdrawal from the reality of God and a flight into fantasies of world government achieved through an unattainable unity. Utopians are undeniably schizophrenic. They want a heaven on earth, which can only be achieved by coercion and enslavement. But perhaps what they really want, as depraved human beings, is coercion and enslavement, and use utopian idealism to deceive and entrap the gullible. Nor is it by accident that the government schools now lavish so much time on death education, which has been marbleized throughout the curriculum. As Dr. Rushdoony writes: 'For man to turn his back on God, therefore, is to turn towards death.' And this is exactly what the government schools have done. Add to this, multiculturalism, transcendental meditation, sensitivity training, explicit sex education, drug education, evolution, behavioral psychology, humanism, whole language, and other such programs, and you get a curriculum that is so profoundly anti-Christian that one wonders how any Christian parent or minister can condone putting a Christian child in a government school from the forward by Samuel L. Blumenfeld. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Child's Creation of a Pictorial WorldEllen Handler SpitzThe Child'S Creation of a Pictorial World, by Claire Golomb. Mahwah, New Jersey: Erlbaum, 2004, 388 pp.Children's drawings fill us with wonder and delight. They may tend, however, to puzzle us, especially if we seek to comprehend them in terms appropriate to the drawings of mature artists or in terms relevant for other pictorial forms and expressions. Likewise, they may (...) puzzle us if we make the mistake of supposing that they represent in any direct or obvious way the cognitive development of young children or if we see them only as comical, inept efforts at depicting external reality. Children's drawings stimulate many nagging questions, among them the one as to why it should be that a child who knows so much and who is verbally so articulate may be graphically capable of depicting so little.Claire Golomb's work has proven extraordinarily helpful here as a corrective because Golomb, after many years of research and reflection, writes about these youthful creations not as "print-outs" of a child's mind. She sees them, rather, as exemplars of particular visual representational schemata that are generally available to and employed by young children. And although she regards these schemata as universal, she acknowledges that they are clearly subject to a wide range of individual variability. Over all, the value of Golomb's work lies in her extensive, descriptive research. Acknowledging her intellectual debt to her mentor, Rudolph Arnheim, Golomb reminds her readers that representation is never mimesis pure and simple. Representation is never, she tells us, the result of an "intention to copy nature." Therefore, when young children do otherwise, they ought not to be seen as failing. Their drawings ought not to be viewed as unsuccessful attempts to imitate nature or to depict with faithful realism what appears before their eyes. Rather, as Golomb states and attempts to demonstrate throughout the pages of her well-illustrated volume, children employ graphic schemata that develop over time in terms of shape, color, content, and composition. Ever seeking meaning, children create pictorial worlds that, while they have no one-to-one correlation with the perceptual world, are tied to it, importantly, nonetheless.Golomb assiduously describes and illustrates each of her studies so that her readers are treated to a panorama of this "orderly progression," as she puts it, this evolution of children's graphic work. Her book, moreover, is characterized by a certain social scientific aura; that is to say, she proffers statistics and quantifies her data to prove her points. She takes pains to argue, for example, from research conducted in tandem, apparently, with her daughter, that it is extremely difficult to differentiate, prima facie, the drawings of children who have been diagnosed as disturbed from those who are considered normal. Having worked for a couple of years in a residential treatment center for schizophrenic children, I would aver that this claim might be debatable. However, were one to be [End Page 120] able to so differentiate, this might constitute a challenge to Golomb's theory that the representational schemata are, as she puts it, "robust." According to her findings, they remain more or less in tact. Likewise with regard to the issue of cultural variables. Here Golomb argues, gently and respectfully, against positions taken by two other well-known scholars in the field, Brent and Marjory Wilson, who accord a higher priority than she does to cultural differences. According to the Wilsons, children's drawings are importantly influenced by whatever graphic models are made available to them in a given culture. For Golomb, however, these variables, while significant, do not interfere substantially with the universal classifications she proposes. As she writes, "The drawings of young children are as different one from another as fingerprints, yet they can be classified" (357).In general, then, the body of work Golomb offers in this second edition of her first volume published under the same title in 1992 by the University of California Press importantly contributes, as it initially did, to ongoing research in numerous fields, including art education, early childhood studies, art history, developmental psychology, anthropology, and art... (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The bioethics (...) discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)