As a philosophy of meaning (Crowell, 2001), phenomenology is intended here as an enterprise where the distinction between the meaning of the world and its being is not a straightforward one (Zahavi, 2017). Although our investigation is not concerned with metaphysical issues about the constitution of reality, delusion—often characterised as a misrepresentation of basic observational facts about the world—calls into question the common-sense understanding of everyday life. By bracketing our assumptions about what is ordinarily taken to be the primary source of meaning, phenomenology allows us to take a fresh, unprejudiced look at the lived experience of delusion to see if we can make sense of it. Momentarily setting aside “the good, the true, and the beautiful” as the greatest sources of meaning in life (Metz, 2011), a critical engagement with the phenomenological method allows us to discover hidden meaningfulness within the irrational, the harmful, and the incomprehensible.
A long tradition of phenomenological psychopathology has attempted to rescue the ‘voice of madness’ from a priori attributions of meaninglessness by gaining access to the first-person perspective. Indeed, most phenomenologists would agree that “it is impossible to define delusion without being concerned with the patient’s experience” (Parnas, 2004, p. 151). This perspective opens up a world of new meanings where something more ‘fundamental’ about human existence is revealed (Sass, 2019).
Following this lead, we draw on phenomenological insights to support the claim that delusions are not just the result of applying idiosyncratic ‘framework propositions’ to one’s experience of reality (Campbell, 2001) but arise in the context of a global transformation of the ontological framework of experience (for a comprehensive critical overview, see Feyaerts et al., 2021). Next, we go on to show how delusions can make sense and give meaning to our experiences, in the context of a general disintegration of previously taken-for-granted meaning patterns. Drawing on the influential book Madness and Modernism by Sass (2017), we argue that the very alienating character of some delusional states, along with an intense self-awareness and rejection of common-sense conventions, can enhance meaning in life by opening up new possibilities for creative expression.
What is it like to experience a delusion?
In his most important and foundational contribution to the field of psychopathology, Jaspers (1963) is clear on the fact that criteria of certitude, falsity/implausibility, and incorreggibility merely point to external characteristics of delusions—which do not take us very far in our inquiry into their psychological nature or meaning. If we want to move beyond these mere external features, Jaspers writes, we need to confront the question: “what is the primary experience traceable to the illness and what in the formulation of the judgment is secondary and understandable in terms of that experience?” (p. 96). Only by addressing this question, we may identify what is phenomenologically peculiar about delusional experience, or in other words, what makes an experience delusional in the first place. This is no simple task for the phenomenologist, who is soon confronted with “quite alien modes of experience [which] remain largely incomprehensible, unreal and beyond our understanding” (p. 98, abridged). But this should not be a reason to stop trying to understand. Indeed, there is much that can be learned by way of getting closer to the primary experience itself: “we find that there arise in the patient certain primary sensations, vital feelings, moods, awarenesses” (p. 98). In the context of primary delusions (more commonly found in schizophrenia) such feelings and sensations form a well characterised and distinct clinical phenomenon called ‘delusional atmosphere’ or ‘delusional mood’—which remains however extremely difficult to describe due to the very strangeness and ineffability of the experience itself. Consider for example the following first-person account, proceeding by metaphor:
Objects are stage trappings, placed here and there, geometric cubes without meaning. People turn weirdly about, they make gestures, movements without sense; they are phantoms whirling on an infinite plain, crushed by the pitiless electric light. And I - I am lost in it, isolated, cold, stripped purposeless under the light. A wall of brass separates me from everybody and everything. In the midst of desolation, in indescribable distress, in absolute solitude, I am terrifyingly alone; no one comes to help me. This was it; this was madness […] Madness was finding oneself permanently in an all embracing Unreality. I called it the “Land of Light” because of the brilliant illumination, dazzling, astral, cold, and the state of extreme tension in which everything was, including myself. (Sechehaye, 1970, p. 33)
Jaspers describes it as follows:
Patients feel uncanny and that there is something suspicious afoot. Everything gets a new meaning. The environment is somehow different—not to a gross degree—perception is unaltered in itself but there is some change which envelops everything with a subtle, pervasive and strangely uncertain light. A living-room which formerly was felt as neutral or friendly now becomes dominated by some indefinable atmosphere. Something seems in the air which the patient cannot account for, a distrustful, uncomfortable, uncanny tension invades him. (Jaspers, 1963, p. 98; emphasis original)
People often struggle to communicate their puzzling experience through language and some describe living in a ‘real simulation’ or a ‘fake reality’ reminiscent of the movie The Truman Show. In these moments, other people may look like mannikins, puppets or robots wearing a mask, or they may appear two-dimensional as if they were artificially projected on the backdrop of a theatrical scenery (Sass, 2017, p. 29). Accounts from the phenomenological literature show the destabilisation of previously taken-for-granted meanings, whereby people with delusions feel completely lost outside of the pre-reflective and normative matrix of accepted meanings (Pienkos et al., 2017). For example:
I guess it is mostly like, that’s what I can describe it, as a dream, but it’s also like is this actually my life, is this actually what I perceive it to be, or am I actually like, that big philosophical thing that you see in movies, if you zoom out, is this actually the universe, or just some kind of an amoeba in a petri dish in some kind of larger universe. (Pienkos et al., 2017, p. 198)
Life seems to have lost its reassuring sense of reality and has taken on the precariousness of a lucid dream. Most often the delusional atmosphere is fraught with anxiety, disquietude and anguish, but the ‘lucid dream’ can be perceived in some cases as an exciting and illuminating experience. There is an increasing tension coupled with an unbearable sense of ambiguity and uncertainty about the future. Objects seem to be floating free from their background (Matussek, 1987), disconnected from their habitual meaning frameworks while the everyday world is undergoing some sort of inexplicable metamorphosis. This in turn triggers an exaggerated and morbid hyper-rationality and introspective activity, whereby people with delusions seem to gain access to certain ontological facets of human life that remain usually unattended and too often neglected (Sass, 2019).
This is reminiscent of Heidegger’s experience of Angst. For Heidegger (2007), Angst is not a meaningless phenomenon (even if in it we are not able to carry out our everyday life), rather it provides a special access to the ontological (Withy, 2015, pp. 77–92). Something very real about the human condition is revealed through Angst, namely the possibility of not being oneself. Having acknowledged our perpetual “fall” into everydayness and inauthenticity, the possibility of becoming who we really are (authenticity) is opened up; we are called upon to be ourselves. Alice Holzhey-Kunz (2020) refers to Angst as a fundamental philosophical experience that tells us an unfathomable truth about human life, which is necessarily forgotten by normal people when attending the demands of everyday life. This truth entails the burdensome awareness that our life is fundamentally dominated by the law of time and its finitude cannot be escaped. This raises the question: can delusional forms of existence unveil something about the meaning of life?
Delusions as discovery and revelation
In the section above, we have referred to some phenomenological accounts of the perceptual alterations that characterise pre-delusional states, wherein the very sense of reality seems to go awry and the agent is lost in a permanent state of “something is going on; do tell me what on earth is going on” (Jaspers, 1963, p. 98). The German psychiatrist Klaus Conrad, in his seminal work on the formation of schizophrenic delusion (Conrad, 1958), calls this initial phase “Trema”, emphasising the expectational and suspenseful character of the experience—similar to the actor’s “state of tension” (“Spannungszustand”) before going on stage. In Conrad’s model, the “trema” phase is often followed by or intertwined with delusional mood and includes a number of different emotional, affective and atmospheric features such as an increased basic affective tone, mistrust and depressive-like mental states such as guilt, anxiety, and fear of death (Henriksen & Parnas, 2019, pp. 747–750). Growing out of the “trema”, the delusional mood becomes increasingly self-referential; the neutrality of the experiential background is lost and whatever is happening or about to happpen is directed against the subject. This stage may progress into Apophany (Greek apo [away from] + phaenein [to show]), wherein the delusional meaning is experienced as a revelation or “Aha-Erlebnis” which alleviates the previous unbearable sense of impending doom. In the apophanic stage, one promptly makes sense of what was previously only alluded to and is struck by a revelation. This opens up a new, hidden meaning intended especially for that person.
Jaspers similarly describes the sudden formation of delusional ideas following delusional atmosphere, as in this example from the writings of a patient:
It suddenly occurred to me one night, quite naturally, self-evidently but insistently, that Miss L. was probably the cause of all the terrible things through which I have had to go these last few years (telepathic influences, etc.). I can’t of course stand by all that I have written here, but if you examine it fairly you will see there is very little reflection about it; rather everything thrust itself on me, suddenly, and totally unexpected, though quite naturally. I felt as if scales had fallen from my eyes and I saw why life had been precisely as it was through these last years…(Jaspers, 1963, p. 103)
Jaspers recognises the soothing effect provided by the experience of finding “a fixed point” to cling on:
this general delusional atmosphere with its vagueness of content must be unbearable. Patients obviously suffer terribly under it and to reach some definite idea at last is like being relieved from some enormous burden […] the achievement of this brings strength and comfort, and it is brought about only by forming an idea, as happens with health people in analogous circumstances (Jaspers, 1963, p. 98).
Here the emergence of the belief out of the delusional atmosphere appears as something meaningful, possibly also warranted and necessary to resolve a situation of indefinite anticipation. Many would indeed agree that searching for meaning is a fundamental human need in the context of any life event, and this applies to a greater extent when we are confronted with ambiguity and uncertainty. Some authors (Maher & Ross, 1984) have suggested that the person engages in a process of empirical observations and hypothesis testing, which is not dissimilar from that of the researcher trying to unravel a scientific mystery. The long sought missing detail finally provides the explanatory insight that solves the enigma and dissipates anxiety, perplexity and confusion—thanks to the formation of a delusion. This is a sort of eureka moment when everything falls into place and a new understanding of reality is established, which brings forth a sense of relief. Framed in this way, the newly developed delusional framework can be viewed as meaningful and adaptive insofar as agents are relieved of negative feelings and acquire the necessary hermeneutical, affective and pragmatic resources to understand their world and invest in foreseeable challenges. While bringing forth a sense of relief and new affordances, however, this shift in perspective may also undermine habitual and trusted views of oneself, others and the world, fuelling what Sips calls a dialectic of aha- and anti-aha experiences (Sips, 2019; Van Duppen & Sips, 2018). The notion of anti-aha experience highlights the dynamic involvement of one’s personal and interpersonal contexts and narratives in making sense of delusional experiences and initiating problem finding, which in some cases may lead to transformative and spiritual growth (Nixon et al., 2010).
Sass and Pienkos (2013) have suggested other possible compensatory features of delusion, for example related to the wish of some people to escape a reality that is either intolerable, unsatisfying or unsafe. In these cases, the delusional reality may provide additional meaning in life, a sort of preferred reality where the agent is protected from unbearable suffering, pain, depression and in some cases suicidality such as in the case of Barbara discussed earlier (Gunn & Bortolotti, 2018).
The new meaningfulness unveiled through the delusional experience can take up different themes—for example persecutory, grandiose, religious, somatic and so on. Phenomenologists have suggested that some schizophrenic delusions are concerned with “ontological” themes about the metaphysical status of the universe (Parnas, 2004), rather than mundane or “ontic” affairs. Ke̜piński (1974) describes three main metaphysical taints that often colour schizophrenic delusions: ontological (e.g., about the nature of being), eschatological (e.g., about the end of the world, and charismatic (e.g., about the meaning of life). He says:
the patient is not inactive when the world is exposed to apocalyptic events. He is in the central position of that world. He may feel immortal, immaterial, almighty, as God or devil; the fate of the world depends upon him […] The world is threatened by annihilation, and the patient wants to warn mankind, offer himself for the sake of humanity […] The meaning of his life reveals itself to the patient: a great mission, an act of heroism, martyrdom. (transl. in Bovet & Parnas, 1993, pp. 121–122; our emphasis).
Therefore, through the development of delusion, life seems to gain a new meaning where the person often feels superior, exceptional, and closer to the truth. The poet Gerard de Nerval, in his illness memoir Aurelia, rejoices while recounting the things he has seen as a spirit: “how happy I was in my new-found conviction! Those lingering doubts about the immortality of the soul which beset even the best of minds were now laid to rest. No more death, no more sorrow, no more anxiety” (Nerval, 1999, p. 277).
Considering the sense of enlightenment and truthful perfection that pervades these delusional worlds, it would seem counterintuitive to dismiss such instances as senseless speech, devoid of any meaning. However, it would be misleading to think that all delusions are accompanied by joyful feelings and experienced with a positive outlook. More often than not, in the context of severe mental disorders such as schizophrenia, delusions may bring about intense feelings of paranoia, fear, apprehension, anguish, guilt, shame, depression, or even annihilation. The very sense of existing as a unified, separate being might be affected (Parnas & Sass, 2001). People with delusions may report being constantly followed, laughed at, spied upon, or poisoned. Privacy and ego boundaries can be seriously damaged to the extent that “a schizophrenic may say that he is made of glass, of such transparency and fragility that a look directed at him splinters him to bits and penetrates straight through him” (Ratcliffe & Broome, 2012). Some people describe losing control over their own actions, as if an alien force were controlling their movements or their thoughts. Some believe that their thoughts have been implanted into their brain by an alien force and are being broadcasted across the world. The end of the world might be impending. In no ways can the person be reassured of the unlikelihood of such a catastrophic event: “everything is so dead certain that no amount of seeing to the contrary will make it doubtful” (Jaspers, 1963, p. 104).
In these cases, a new sense-making is established out of the delusional mood albeit one that leads to a world of persecution and isolation. Communication with the person might become difficult because there is no shared background of significance on which the intersubjective world can be co-constituted (Fuchs, 2020). The possibility of a shared reality is taken over by a solipsistic world-view, where the self is entrapped amid paradoxical feelings of centrality and self-dissolution (Parnas & Sass, 2001).
Can such an extreme existential position still be meaningful? A distinctive meaningfulness of solipsistic acts can certainly be claimed inasmuch as it provides a sort of adhesive, holding together the pieces of a shattered self (Humpston, 2018). This view is grounded on the idea that schizophrenic delusions originate on the background of pre-existing disturbances of the basic sense of self (or minimal self), as conceptualised in the ipseity disturbance model of schizophrenia (Sass et al., 2018). On this account, certain instances of bizarreness can be explained as the result of three interconnected aspects of self-disturbance: (1) diminished self-presence, referring to a reduced sense of existing as a living agent; (2) disturbed grip or hold on the world, that is a destabilisation of the meaning-structure, salience-pattern or reality status of the world; (3) hyperreflexivity in the sense of an exaggerated—mainly avolitional—reflective consciousness (Sass & Byrom, 2015). Hyperreflexivity leads to increasing objectivation of introspective experience whereby tacit and automatic phenomena become focal objects of awareness. This sort of detached hyperconsciousness need not be inherently pathological or uniquely present within schizophrenia. Affinities have been observed between certain kinds of anomalous self-experience and, for instance, states of intense introspection or meditation such as those sought after by modernist and post-modernist artists (for example within Surrealism and Russian Futurism art movements). In these contexts, a volitional kind of hyperconsciousness was considered a fundamental aesthetic practice aimed at suspending the conventional meaning attributions to unveil the concreteness and abstract particularity of external objects (Sass, 2017).
Delusions and creativity
So far, we have come to appreciate the sense-making features of some delusions which arise in the context of a puzzling and uncanny pre-delusional state. On this account, delusions can be meaningful insofar as they afford existential rescue from the uncertainty of a shattered sense of presence. As a patient with schizophrenia puts it: “Delusions are an attempt to explain a very deep restlessness. It is an attempt to seek rescue in a story in which you eventually get lost” (Henriksen et al., 2010, p. 366). Through this process, a new narrative is created that re-establishes a sense of coherence, yet appears fundamentally disconnected from the shared world. The structuring of a new meaning, often characterised by a self-reflective and hyper-aware focus on theoretical and metaphysical aspects of experience, is coupled with a de-structuring of practical, ontic, or common-sense meanings that provide the experiential background for mutual understanding and sharing of social practices. Indeed, it is not surprising that “dissociality” (or “social dysfunction” in DSM terminology) is a fundamental feature of schizophrenia which is typically characterised as the lack of appropriate interpersonal skills, failure of social adjustment or withdrawal from social life (Stanghellini & Ballerini, 2011). In keeping with a “deficit” view of schizophrenia (i.e., it falls short of some standards of “goodness”), we often find delusion being related to a fundamental lack of or decline in certain end values of intellectual attainment, moral fulfilment, and aesthetic worth. While these are certainly promising candidates for our search into what makes a life meaningful (Metz, 2011), we believe that they are not the only places where meaningfulness can be found. For this quale might be concealed in certain unconventional modes of being in the world that have been traditionally associated with notions of emptiness, defect and insanity. One way in which the meaningfulness of certain unusual experiences might be accessed is through the analysis of modernist and postmodernist artwork.
In his book Madness and Modernism, Sass (2017) provides a compelling argument for the recovery of the voice of schizophrenia from the defective world of blindness, disease and meaninglessness, where it has been segregated for centuries by most Western ideologies. Sass contrasts the traditional portrait of madness—evoking darkness, demonic forces, and incomprehensible beastlike sounds (epitomised for example in the painting by Francisco Goya “The Madhouse at Saragossa”)—with that of immense, bright and timeless metaphysical landscapes (such as those represented in Giorgio De Chirico’s early canvases such as “Melancholy of a beautiful day” or “The enigma of a day”). Here there is no spontaneous and passionate expression of the primordial unity between the self and the world—as considered in post-romantic terms—but an all-encompassing and enigmatic sense of significance that refers to neither the self nor to the world but to the very act of consciousness. When the meaning of life—as conceived of in our everyday mundane dimension of living—disintegrates, what is it to be found under the familiar surface of reality? By affording deeper insights into the nature of existence, unusual experiences such as those arising in the context of the prototypical surrealist mood (as a sort of intense and detached introspection), have often been regarded as a mysterious source of artistic creativity. The parallel that Sass has been able to draw so cogently with the state of delusional mood remains however contentious in other pathographical readings of modern poetic and artistic work. Indeed, the beneficial impact of psychotic processes on meaningfulness can be difficult to defend, while simultaneously acknowledging the inescapable destructive effects of the illness over time.
Jaspers was fully aware of this psychological and existential conundrum when he wrote: “Just as a diseased oyster can cause the growth of pearls, by the same token schizophrenic processes can be the cause of mental creations of singular quality” (Jaspers, 1977, p. 134). In his pathographical analysis of Friedrich Hölderlin and Vincent van Gogh, Jaspers recognises the meaningful interplay between the extraordinarily talented personalities and their psychotic suffering. Referring to the acute onset of illness in Hölderlin, Jaspers describes a period filled with disintegrating forces and disciplining attitudes where the poet attempts to preserve a sense of coherence, order, and meaning in the face of other-worldly dangers and divine revelations (Jaspers, 1977, p. 146). Though clearly immersed in a delusional reality imbued with mythical actuality, Hölderlin’s “philosophy of life, formerly filled with longing, with conflict, suffering and remoteness, becomes during the period of the schizophrenic process more actual, more immediate, more fulfilled, elevated at the same time into a more general, objective, impersonal, timeless sphere” (Jaspers, 1977, p. 144).
Moreover, in his comparison between Hölderlin and van Gogh, Jaspers emphasises how both artists had a similar experience, following the first acute onset of psychosis—which he describes as follows:
“a preliminary state of philosophical turbulence, coupled with an increased feeling of security and of a nonchalant feeling of self-assertion, as well as a noticeable change in the nature of their works which are understood by then as well as others as growth and as the conquest of their goal” (Jaspers, 1977, p. 193).
It seems therefore fitting to defend a contribution of the delusional experience towards enhancing meaningfulness, though recognising the deleterious long-term effects of the schizophrenic condition, which was eventually evident in the final phase of both artistic lives. This is certainly not to say that suffering is necessary to make a life meaningful, but rather that—under certain conditions—delusional experiences can contribute to the sense that our lives are coherent, directed and worthy of investment. Exemplar cases of superlative meaningfulness, such as the lives of Hölderlin and van Gogh, further suggest that delusion can contribute towards the achievement of great significance. In these cases, however, the meaningfulness arising from the realisation of such superlative projects is critically intertwined with significant psychological costs and existential challenges connected with chronic illness.