Michel Cermolacce

The “minimal self” in psychopathology: Re-examining the self-disorders in the schizophrenia spectrum☆

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.

Multiple Realities and Hybrid Objects: A Creative Approach of Schizophrenic Delusion

Delusion is usually considered in DSM 5 as a false belief based on incorrect inference about external reality, but the issue of delusion raises crucial concerns, especially that of a possible (or absent) continuity between delusional and normal experiences, and the understanding of delusional experience. In the present study, we first aim to consider delusion from a perspectivist angle, according to the Multiple Reality Theory (MRT). In this model inherited from Alfred Schütz and recently addressed by Gallagher, we are not confronting one reality only, but several (such as the reality of everyday life, of imaginary life, of work, of delusion, etc.). In other terms, the MRT states that our own experience is not drawing its meaning from one reality identified as the outer reality but rather from a multiplicity of realities, each with their own logic and style. Two clinical cases illustrate how the Multiple Realities Theory (MRT) may help address the reality of delusion. Everyday reality and the reality of delusion may be articulated under a few conditions, such as compossibility [i.e., Double Book-Keeping (DBK), in Bleulerian terms] or flexibility. There are indeed possible bridges between them. Possible links with neuroscience or psychoanalysis are evoked. As the subject is confronting different realities, so do the objects among and toward which a subject is evolving. We call such objects Hybrid Objects (HO) due to their multiple belonging. They can operate as shifters, i.e., as some functional operators letting one switch from one reality to another. In the final section, we will emphasize how delusion flexibility, as a dynamic interaction between Multiple Realities, may offer psychotherapeutic possibilities within some reality shared with others, entailing relocation of the present subjects in regained access to some flexibility via Multiple Realities and perspectivism.

Contents Vol. 50, 2017

Founded 1897 as “Monatsschrift für Psychiatrie und Neurologie”, continued 1957–1967 as “Psychiatria et Neurologia”, continued 1968–1983 as “Psychiatria Clinica” Founders: C. Wernicke and Th. Ziehen Successors: K. Bonhoeffer (1912–1938), J. Klaesi (1939–1967), E. Grünthal (1953–1973), N. Petrilowitsch (1968–1970), Th. Spoerri (1971–1973), P. Berner (1974–1999), E. Gabriel (1974–2004), Ch. Mundt (2000–2011)

New Insight into Affectivity in Schizophrenia: from the Phenomenology of Marc Richir

Background: According to Karl Jaspers, psychopathology requires a comprehensive method, understood as a systematic exploration of the first-person perspective of the patients experience. At the same time, however, schizophrenia for Jaspers is characterized by its radical incomprehensibility. In addition, Rümkes so-called “praecox feeling” paradoxically combines the incomprehensibility of schizophrenic experience and the evidence of its pathological manifestation in the encounter. Aim: Through a re-examination of the notions of affectivity and interaffective contact we propose a coherent theoretical model to explain the clinicians paradoxical understanding of schizophrenia. Method: Phenomenological tradition regards affectivity as an encompassing phenomenon that connects body, self, world, and others. In our view, only a thorough and systematic link between corporeity and affectivity is able to explain embodied affective resonance as a basis of empathic comprehension. By drawing on the phenomenology of Marc Richir, we will systematically unfold the complex nature of affectivity and lead it back to a twofold constitution of corporeality. Conclusion: The Richirian account on affectivity can be fruitfully put into discussion with other recent phenomenological models on schizophrenia. It might be able to exhibit affectivity as the operative ground of minimal self-disturbance and thus argue for its intersubjective dimension.