Lecture 28

Abstract

The examples of acute mental illness that I have presented to you so far can be regarded as relatively pure and simple cases of acute somatopsychosis and acute allopsychosis, since the main elementary symptoms in the first consisted of disturbances of secondary identification in perception of physicality; and in the second in perception of the outside world. These disturbances of identification themselves involved exclusively the sensory domain, that is the relationship of s to A in our schema, even if, in detail, the subgrouping of symptoms as either anaesthesia, paraesthesia, or hyperaesthesia was often left in doubt, and open to discretion. If we are to pursue previously developed ideas about psychological mechanisms in a consistent fashion, we come to the question: Are there analogous disturbances of secondary identification in the third area of consciousness that we differentiated—that of personhood. In other words, just as our schema assumed centripetal conduction extending via the next sensory projection field into associated projection fields, can it also apply to interrelationships forming much more complicated associative complexes? Clearly an answer can be provided only from experiences in the clinic, since our whole schema can claim to be no more than a convenient aid for representing symptoms objectively, which is so extraordinarily difficult in our field. You will have already gathered from introductory comments at the beginning of our demonstrations that it has become necessary, just as with somatopsychic and allopsychic disorientation and disarray—and we had also got to know of motor disorientation and disarray—that we acknowledge autopsychic disorientation and disarray as effects of acute psychoses (p. 135).