Clinical manifestations of self-disorders and the Gestalt of schizophrenia

Anomalies of self-experience (self-disorders) constitute crucial phenotypes of the schizophrenia spectrum. The following qualitative study demonstrates a variety of these core experiential anomalies. From a sample of 36 first-admitted patients, all of whom underwent a comprehensive psychiatric evaluation, including the EASE scale (Examination of Anomalous Self-Experience), 2 schizophrenia patients were selected for detailed psychopathological presentation and discussion. The vignettes provide prototypical examples of what has been termed self-disorders in schizophrenia, ie, pervasive and enduring (mainly) trait phenomena which constitute essential aspects of the spectrum

Self-disorders: A promising Candidate for Early Detection

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Mysticism and schizophrenia:A phenomenological exploration of the structure of consciousness in the schizophrenia spectrum disorders

AbstractMysticism and schizophrenia are different categories of human existence and experience. Nonetheless, they exhibit important phenomenological affinities, which, however, remain largely unaddressed. In this study, we explore structural analogies between key features of mysticism and major clinical-phenomenological aspects of the schizophrenia spectrum disorders—i.e. attitudes, the nature of experience, and the ‘other’, mystical or psychotic reality. Not only do these features gravitate around the issue of the basic dimensions of consciousness, they crucially seem to implicate and presuppose a specific alteration of the very structure of consciousness. This finding has bearings for the understanding of consciousness and its psychopathological distortions

Self-disorders and schizophrenia:A phenomenological reappraisal of poor insight and non-compliance

Poor insight into illness is considered the primary cause of treatment noncompliance in schizophrenia. In this article, we critically discuss the predominant conceptual accounts of poor insight, which consider it as an ineffective self-reflection, caused either by psychological defenses or impaired metacognition. We argue that these accounts are at odds with the phenomenology of schizophrenia, and we propose a novel account of poor insight. We suggest that the reason why schizophrenia patients have no or only partial insight and consequently do not comply with treatment is rooted in the nature of their anomalous self-experiences (ie, self- disorders) and the related articulation of their psychotic symptoms. We argue that self-disorders destabilize the patients’ experiential framework, thereby weakening their basic sense of reality (natural attitude) and enabling another sense of reality (solipsistic attitude) to emerge and coexist. This coexistence of attitudes, which Bleuler termed “double bookkeeping,” is, in our view, central to understanding what poor insight in schizophrenia really is. We suggest that our phenomenologically informed account of poor insight may have important implications for early intervention, psychoeducation, and psychotherapy for schizophrenia

Disordered Self in the Schizophrenia Spectrum:A Clinical and Research Perspective

LEARNING OBJECTIVES: After participating in this activity, learners should be better able to: 1. Assess anomalous self-experience as a core feature of schizophrenia spectrum disorders. 2. Evaluate current and historical research regarding disorders of self-experience in schizophrenia. ABSTRACT: This article explores the phenomenological and empirical rediscovery of anomalous self-experience as a core feature of the schizophrenia spectrum disorders and presents the current status of research in this field. Historically, a disordered self was considered to be a constitutive phenotype of schizophrenia. Although the notion of a disordered self has continued to appear occasionally over the years—mainly in the phenomenologically or psychodynamically oriented literature—this notion was usually considered as a theoretical construct rather than as referring to concretely lived anomalous experiences. Empirical research on the disorders of self-experience in schizophrenia can be traced back to the US-Denmark psychopathological collaboration in the well-known adoption and high-risk studies, which aimed at identifying trait or phenotypic vulnerability features. This research was later followed by clinical work with first-admission schizophrenia patients. We offer clinical descriptions of anomalous self-experience and outline the phenomenological structures of subjectivity that are needed for grasping the nature of these anomalous experiential phenomena. What appears to underlie these experiences is an instability of the first-person perspective that threatens the basic experience of being a self-coinciding, embodied, demarcated, and persisting subject of awareness. We summarize a series of empirical studies targeting self-experience in schizophrenia performed prior to and after the construction of a phenomenologically oriented psychometric instrument for assessing anomalies of self-experience, the Examination of Anomalous Self-Experience (EASE). These empirical studies support the classic clinical intuition that anomalous self-experiences form a central phenotype of schizophrenia. Implications for diagnosis and research are briefly discussed

Embodiment and affectivity in Moebius Syndrome and Schizophrenia: A phenomenological analysis

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

Ironi, humor og opgøret med Hegel i Efterskriften

During the last decades, literary studies have shed a long awaited light on the complexities and specificities of Kierkegaard’s writing style. Possibly due to their focus on his so-called aesthetic works, they have left the impression that his style generally is motivated by aesthetic reasons. Contrary to this impression, I argue that Kierkegaard’s style is intrinsically related to the overall project in his authorship, i.e. to become a Christian. In the Postscript, Climacus’ account of what it means to become a Christian is presented largely as a criticism of Hegel’s philosophy and Hegelian theology. In the article, I explore the significance of style for Climacus’ account and I discuss the difference between irony and humour as forms of communication and their inherent limitations. Furthermore, I argue for a connection between irony and humour in the Postscript and what Kierkegaard called “ethical” and “ethical-religious” forms of communication in his unpublished manuscripts