Chapter

Dialogical compromise and psychosocial dysfunction

Paul H. Lysaker and John T. Lysaker

in Schizophrenia and the Fate of the Self

Published on behalf of Oxford University Press

Published in print August 2008 | ISBN: 9780199215768
Published online February 2013 | e-ISBN: 9780191754524 | DOI: http://dx.doi.org/10.1093/med/9780199215768.003.007

Series: International Perspectives in Philosophy & Psychiatry

Dialogical compromise and psychosocial dysfunction

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At the outset of this chapter, we asked whether compromises in dialogical capacities might play a role in psychosocial dysfunction. In reply, we suggested that social forces, which lead to dysfunction such as stigma and oppressive power relationships, may exacerbate and be exacerbated by dialogical compromises. We further argued that knowing and being known by another may animate more self-facets and positions than can be comfortably accommodated by one for whom intra- and interpersonal dialogue is a difficult task. As a result, intersubjectivity may be experienced as a threat and intimacy avoided, two effects that in turn seem to intensify dialogical breakdowns, which leads to a debilitating downward spiral that entrenches social dysfunction and deepens experiences of diminishment. Finally, when considering committed action within the community, we suggested that the dialogical demands of ongoing worldly interaction also bring disorder to the interanimating play of self-positions among people with schizophrenia, thereby leading them to avoid commitment and/or show a lack of perseverance over time. And while we didn’t take the time to argue this, it seems evident that repeated failures of this sort not only contracts one’s intra-and interpersonal dialogues, but also intensifies, with the help of stigma, experiences of diminishment.

Looking at the last two chapters as a whole, we have also argued that a dialogical approach to schizophrenia not only attends to and preserves the first-person dimensions of the illness, but also give us reason to suppose that these dimensions interact with third-person events over the course of the illness. In the cases of positive and negative symptoms, as well as psychosocial dysfunction, we have witnessed some of the ways in which self-disclosures, in the form of interanimating plays among self-positions, might render one vulnerable to and intensify the effects of oppressive social relationships, cognitive deficits, abnormal cortical activity, and so forth. These two chapters thus provide some more evidence for the claim that how one undergoes schizophrenia is relevant to how it unfolds over the course of one’s life.

Chapter.  7799 words. 

Subjects: Psychiatry

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