Abstract
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.
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Notes
For a detailed account of the transition from the delusional mood to overt psychosis in cases of paranoid schizophrenia, see Conrad’s Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns (2002).
Among the few philosophers who, according to Searle, have examined the subject he calls “Background capacities,” is, besides Nietzsche and Bourdieu, Wittgenstein (1992, 177). In a note, Searle even claims that On certainty “is one of the best books on the subject” (1992, 253), thereby indicating a similarity, most likely, between his notion of Background capacities and Wittgenstein’s notion of hinges.
Blankenburg argued that schizophrenia consists in a global crisis of common sense or in a lack of natural self-evidence (1971; 2001). In other words, schizophrenia involves, according to him, an impairment of the ordinary pre-reflective, automatic immersion into the intersubjective world, which constitutes our normal dynamic sense of what is contextually relevant and socially appropriate. One of his patients, a 20-year-old female, described the basic lack she experienced in the following way: “What is it that I am missing? It is something so small, but strange, it is something so important. It is impossible to live without it. I find that I no longer have footing in the world. I have lost a hold in regard to the simplest, everyday things. It seems that I lack a natural understanding for what is matter of course and obvious to others. […] Every person knows how to behave, to take a direction, or to think something specific. The person’s taking action, humanity, ability to socialize…all these involve rules that the person follows. I am not able to recognize what these rules are. I am missing the basics. […] I don’t know what to call this….It is not knowledge….Every child knows these things! It is the kind of thing you just get naturally” (Blankenburg 2001, 307f.).
Thornton has proposed another Wittgensteinian interpretative tool, namely to conceive delusions as expressions of, what Wittgenstein called, secondary sense (Wittgenstein 1997, 216), i.e., a specific way we use words that is neither the primary use nor a metaphorical use, but “one which we find natural given the primary use, but which is discontinuous with, and could not be used to teach, the primary use” (Thornton 2004, 222). As an example, he says (referring to Wittgenstein) that in the utterance “Wednesday is a fat day,” the adjective “fat” is used in a secondary sense. I appreciate Thornton’s proposal because it stresses that the meaning of the patients’ verbal expressions is not univocal and that we always must remain open to several interpretations when considering these expressions. It is, nonetheless, difficult to see how this proposal can aid us in the task of trying to comprehend delusions. Thornton himself explicitly states that the notion of secondary sense perhaps can provide structural descriptions of the delusional expression, but that it does not bring us any further toward an empathic understanding of these phenomena (ibid.).
Such an interpretation has been put forth by Klee (2004). Contrary to Campbell’s proposal, Klee does not propose a parallel between delusions and framework propositions but claims that bizarre or, what he calls, stark delusions necessarily are inexplicable because they involve content that negate our framework propositions and because they cannot be explained by their relations to other beliefs (2004, 31). More specifically, he argues from a Wittgensteinian perspective that by denying the certainties from which the framework emerges, the “framework that makes any kind of psychological explanation possible is missing” (Klee 2004, 32). Although he rejects Davidson’s idea that rationality is constitutive for the attribution of mental content (2004, 31), Klee’s account is strongly influenced by Davidson’s theory and in particular his so-called principle of charity, which requires that the interpreter maximizes the rationality and the self-consistency of the person he seeks to understand (Klee 2004, 31; Davidson 1967, 313). From a Davidsonian perspective, Klee argues that the rationality and the consistency of the patient’s belief system are violated in bizarre delusions, and consequently, that they are inexplicable. However, we can, as Sass has done, question Klee’s notion of psychological explanation; we also frequently find inconsistencies in the belief systems of normal subjects (Sass 2004, 74–76). Sass argues that Klee’s account does not allow us to comprehend “a delusion as anything other than a mistake, or of understanding it in the light of an at least partially comprehensible, although significantly altered, experiential framework” (Sass 2004, 76). I also find Klee’s argument that stark delusions are stark partly because “no one could possibly have predicted the thematic content of their [the individuals’] delusions” (Klee 2004, 33) problematic. This is not entirely correct because although the specific content of a delusion is impossible to predict, Kepinski has, among others, shown that the themes of schizophrenic delusions are metaphysically tainted (ontological, eschatological, or charismatic) in contrast to delusions found in other mental disorders (Kepinski 1974; cf. Bovet and Parnas 1993, 591f.).
For example, communicating (Cf. Wittgenstein’s rejection of the possibility of a private language) and acting seem to undermine the solipsist’s apparent self-sufficiency (Sass 1994, 58). Due to the subjectivization of reality, the solipsist is unable to be in the world because he is the center of the world. In order to act and communicate adequately, the solipsist would have to rely on other subjects and this would undercut his solipsistic stance.
Elyn Saks, a professor and a lifetime sufferer from schizophrenia, describes in a passage from her memoir an experience of dissolving: “And then something odd happens. My awareness (of myself, of him, of the room, of the physical reality around and beyond us) instantly grows fuzzy. Or wobbly. I think I am dissolving. I feel—my mind feels—like a sand castle with all the sand sliding away in the receding surf. What’s happening to me? This is scary, please let it be over! I think maybe if I stand very still and quiet, it will stop. This experience is much harder, and weirder, to describe than extreme fear or terror. Most people know what it is like to be seriously afraid. If they haven’t felt it themselves, they’ve at least seen a movie, or read a book, or talked to a frightened friend—they can at least imagine it. But explaining what I’ve come to call ‘disorganization’ is a different challenge altogether. Consciousness gradually loses its coherence. One’s center gives away. The center cannot hold. The ‘me’ becomes a haze, and the solid center from which one experiences reality breaks up like a bad radio signal. There is no longer a sturdy vantage point from which to look out, take things in, assess what’s happening. No core holds things together, providing the lens through which to see the world, to make judgments and comprehend risks” (Saks 2007, 12f.). I quote this long passage not only because it provides a concrete example of a patient’s experience of dissolving, but also because it elucidates why some schizophrenic experiences cannot be understood as mere exaggerations or variations of normal experiences. It seems only logical that such unusual experiences are difficult to grasp as well as to convey to others in usual everyday terms as Saks claims. Schreber is also well aware of these difficulties and he explicitly warns readers not to try to understand his experiences in the light of their own normal experiences because, as he puts it, “matters are dealt with that lack all analogies in human experiences” (Schreber 1988, 117, quoted in Sass 1994, 28).
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Henriksen, M.G. On incomprehensibility in schizophrenia. Phenom Cogn Sci 12, 105–129 (2013). https://doi.org/10.1007/s11097-010-9194-7
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DOI: https://doi.org/10.1007/s11097-010-9194-7