Understanding the Mental Disease of Schizophrenia

Abstract

There are numerous mental diseases that yet require deep investigation in terms of the alteration of the mental state of the patient due to the disease onset. Of course there are other aspects of mental diseases which obviously urgently need exploration, such as cause, cure, etc. However it is only appropriate to consider the alteration of the patient’s mental state in this book. And of all the mental diseases it is schizophrenia which is most relevant in looking for the mental disease with greatest effect on the subject’s mental state. Numerous researchers have pointed out over the last decades that there is a loss of the sense of the inner self in schizophrenia. In particular the illuminating paper of Sass and Parnas (Schizophr Bull 29(3):427–444, 2003) gives an underpinning explanation of the disease along these lines in each of its three manifestations, with positive, negative or disordered symptoms (see also Cermolacce M, Naudin J, Parnas J, Conscious Cogn 16:703–714, 2007; Parnas J, Handest P, Saebye D, Jansson L, Acta Psychiatrica Scandinavica 108:126–133, 2003; Parnas J, Handest P, Jannsson L, Saebye D, Psychopathology 38(5):259–267, 2005; Sass L, Parnas J, Explaining schizophrenia: the relevance of phenomenology. In: Chung MC, Fulford KMW, Graham G (eds) Reconceiving Schizophrenia. Oxford University Press, Oxford, pp 63–95, 2007; Sass L, Madness and modernism. Harvard University Press, Cambridge, MA, 1992). The crucial component of the analysis of these researchers is that of various disturbances in ipseity (the ongoing sense of ‘being there’ accompanying all conscious experience) that can occur for a sufferer, giving a framework with which to understand the disease. Such analyses of schizophrenia in terms of distortions of the self go back much earlier (Berze J, Die Primare Insuffizienz der Psychishcen Aktivitat: Ihr Wesen, ihre Erscheinungen and ihre Bedeutung als Grundstorungen der Dementia Praecox und des hypophrenen Uberhaupt. F Deutke, Leipzig, 1914; Minkowski E, La schizophrenia. Psychopathologie des shizoides et des schizophrenes. Payot, Paris, 1927; Blankenburg W. First steps toward a psychopathology of “common sense (trans: Mishara A). Philos Psychiatry Psychol 8:303–315, 2001; Kimura B, Ecrits de Psychopathologie Phenomenologique. Trans Boderlique. P.U.F, Paris France, 1992; Sass LA, Philos Psychiatry Psychol 8:251–270, 2001). However the more recent work has become more precise and embracing in terms of seeing most forms of schizophrenia as arising from such distortions. It also provides new ways of looking at and diagnosing the disease.