Schizophrenia and the sixth sense

Giovanni Stanghellini

in Reconceiving Schizophrenia

Published on behalf of Oxford University Press

Published in print November 2006 | ISBN: 9780198526131
Published online February 2013 | e-ISBN: 9780191754340 | DOI:

Series: International Perspectives in Philosophy & Psychiatry

Schizophrenia and the sixth sense

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Does this experience of disconnectedness that takes place in the realm of self-awareness share a common root with the experience of disconnectedness taking place in the realm of the social life of schizophrenic persons? This was the Leitmotiv of this paper and I will try to sum up my ideas here. In short, these are the two roots of schizophrenic psychopathology: (1) disorders in self-awareness, implying morbid objectification of sensations and emotions and of bodily and mental functions, and (2) disorders in sense integration, more precisely in sensory-to-sensory and sensory-to-motor integration, implying disorders of attunement (which is based on simulation routines, i.e. the coupling between action perception, simulation of action, and understanding of intentions), and consequently autism.

What we need now is a panoramic view on these two phenomena—anomalous self-experience and autism.

In the section devoted to koiné aisthesis and social attunement I tried to demonstrate, in the light of recent developmental psychology and neurobiology, that Aristotle's koiné aisthesis is not only the basis for the integrated perception of the physical world, but also for the meaningful perception of the others’ behaviours in the social world, since it is the basis for the phenomenon of emotional-affective attunement, which is the prerequisite for the emergence of the social self and of inter-subjectivity.

In the following section, the mutual constraints between sensory self-awareness and inter-subjectivity were outlined, i.e. circular process of the emergence of a core- and a social self: abnormal attunement may de-structure self-perception (but the reverse is also true: attunement may help to re-structure one's own self-experience). It was also suggested that abnormal bodily sensations (coenesthopathies), a very common phenomenon in early phases of schizophrenia, may affect the inter-corporeal resonance on which attunement is based.

Developmental psychology and psychopathological data legitimate to consider that disordered koiné aisthesis is the common ground for schizophrenic anomalous phenomena in self- and social experience. What I would like to suggest in these concluding remarks is that the mode schizophrenic persons relate to the others shares with the mode they relate to themselves the same objectifying attitude. In a nutshell, the social world of schizophrenic persons is a lifeless land. If one feels one's self as a de-animated body, then the others’ bodies are lifeless too. The disintegration of one's own sensory self-awareness implies the impossibility of attunement and without attunement the others are meaningless things—Koerper. Also, if one conceives of oneself as a disembodied spirit, an entity who is split into a spirit watching one's body as an operating mechanism, then the others are pictured as mechanisms too. Social interactions are also mechanical and their performance requires the knowledge of abstract algorithms. If empathic attunement fails, the search for propositional knowledge appropriate to social interactions takes its place. As it happens in self-experience, also in social experience; there is a shift from first-person to third-person perspective: the social world is conceived of as an impersonal game regulated by impersonal norms. The social experience of schizophrenic persons is penetrated through and through by conceptual elements. In such a world, the comment that Walter Benjamin addressed to Paul Valéry in occasion of his sixxty-fifth birthday looks appropriate: ‘He bends himself on facts as if they were nautical charts, and, without being pleased by the sight of ‘depths’, he is just happy to be able to follow a not dangerous route.

Chapter.  8834 words.  Illustrated.

Subjects: Psychiatry

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