The ‘Unconscious’ in Paranoid Delusional Psychosis: Phenomenology, Neuroscience, Psychoanalysis

Abstract

In this contribution I present three overlapping approaches to the phenomenology of the unconscious (Conrad, Binswanger, Husserl). Conrad and Binswanger challenge the classical view that the delusional perception in schizophrenia is an abnormal symbolic meaning attached to an otherwise intact percept.

Jaspers' Critique of Essentialist Theories of Schizophrenia and the Phenomenological Response

“…The patient answers ‘by not having the physical force' to look away. As one of Matussek's [[37], [38], reviewed by [39]] patients later reported, the looking away requires too much effort (Das Wegschauen kostet Mühe) . It is easier to remain transfixed on the same aspect, i.e.…”

“…In short, the ‘I' obtains and ‘maintains' a level of tonicity of consciousness to resist being overpowered by the impressional sphere (as the impressional and intentional spheres are antagonistic to one another). As later developed by Binswanger, Straus, Conrad, and other phenomenological psychiatrists, there is - with the reduction of intentionality and mental acts - a loss of distance to the impressional sphere (experienced as alterity, being at the disposal of alien intentionality, or the inability to transcend the current momentary perspective) [see [12,39] for reviews].…”

“…Binswanger expressed the view that Husserl's method of eidetic or essential seeing or imaginative variation has particular promise in studying the subjective experience of patients with schizophrenia without reverting back to the earlier reifying theories of proposing a realistic essence of schizophrenia. Husserl's method of imaginative variation or ‘essential-seeing' as an ‘abstracting, or delimiting the meaning of an object by means of imaginative variation of its limits, establishes the formal conditions of its possibility [39,42]. By suspending our belief in the object's actual reality (Step 1), we explore its possible imagined, variant meanings (latent or implicit to the initial perception) (Step 2).…”

“…In his final work, a phenomenology of delusion [29], he took up Matussek's [37,38] and Conrad's [56] criticisms of the Heidelberg School's (Jaspers, Gruhle, K. Schneider) by then ‘classical' position that the delusional perception in schizophrenia is an abnormal symbolic meaning attached to an otherwise intact percept. Following Matussek's view that a perceptual aspect or expressive (physiognomic) quality, detached from its visual context, becomes salient and develops into the delusion, Conrad and Binswanger believed that delusional perceptions involve a transformation of perceptual gestalt meaning on a ‘lower' unconscious, automatic phase of the development of perceptual meaning, but they applied different methods [39]. …”

“…It is easier to remain transfixed on the same aspect, i.e. perceptual rigidity (Wahrnehmungsstarre) [37,38,39]. These reductions in initiative (Mangel an Initiative) result in a weakening of will (Schwächung des Willens) and thereby also attention [7].…”