Abstract
The first part of this article dealt with the extant formulations of delusion, psychiatric and psychological, suggestions which, respectively, regard delusion as psychologically inexplicable or explicable. All this was subjected to critique. This second part puts forward informed philosophical thesis whereby delusion can be explained within the philosophical movement known as phenomenology and, in particular, Max Scheler’s version of this.
[Part 1 was published in History of Psychiatry 26(4): 404–417]
Delusion as philosophically explicable
Preamble
Most of the great psychiatrist psychopathologists of the last 100 years had a sense that only a philosophical input into the subject could illuminate the nature of delusion. Minkowski (1927/1987) invoked Bergson, Kulenkampff (1956) found insights in Sartre’s work, and Fuchs (2005) and Andersch (2014) in Merleau-Ponty’s and Cassirer’s, respectively. Stanghellini (2004) even resorted to Aristotle. Most, however, placed their reliance on the trio of acknowledged founders of the philosophical phenomenological movement – Husserl, Scheler and Heidegger. Binswanger (1957, 1965) vacillated between the influences of Husserl and Heidegger; Wiggins and Schwartz (2007) opted for Husserl’s philosophy; Kuhn (1952) and Kraus (2007) saw Heidegger’s philosophy as the way forward for their purposes; and Kurt Schneider (1920/2012), Straus (1938/2012) and von Gebsattel (1938/2012) were acquainted with Scheler’s early work and applied it to psychopathology, though not specifically to delusion.
What stands out in all this, for the furtherance of the problematic of delusion, is that psycho-pathologists who preceded us in this endeavour were themselves attracted to those aspects of their philosophical mentor’s work which highlighted a duality at the heart of the human being. So, for example, delusion for Kuhn and Kraus came about through an inappropriate shift from the sort of knowledge labelled Zuhandenheit by Heidegger – a subconscious spatial array of implements intrinsic to a pragmatic way of being – to Vorhandenheit – an objectified spatial assembly of things seemingly completely independent and preceding (hence Vorhandenheit) our concerns. Minkowski’s (1927/1987) particular interest in Bergson was also focused on the duality which Bergson brought out between a temps vécu (a subconsciously, lived time underpinning life) and spatially laid out and consciously experienced snapshots of this, which he, Minkowski, thought could be exaggerated and inappropriate in a schizophrenic’s life. Two psychopathologists – Zutt (1952/1963) and Tatossian (1979) – who were both knowledgeable about modern philosophy but who had no particular mentor in this respect, realized that what characterized the schizophrenic modus vivendi and, by extrapolation, led them into delusional frameworks, was an inflexibility or lack of freedom in adopting more than one viewpoint on matters, i.e. a one-sided take on what is actually a multifarious situation.
With all this in mind we offer the following philosophical exegesis of delusion.
Which philosophical psychopathology?
First, we need to justify our philosophical framework for the task. We take the view that the phenomenological movement in philosophy in the early decades of the twentieth century comprises a body of knowledge about the human being unsurpassed by anything preceding it. You might say, why not a Platonic or Hegelian psychopathology? We reply, you could well develop one, but no one else has found this a compelling project, whereas dozens of psychopathologists have found the work of Husserl, Scheler or Heidegger immensely stimulating for their purposes.
Of the three, we find the work of Scheler superior to the others for our needs because he avoided the one-sidedness that blights their philosophies. Husserl, for all that his supporters praise his late conversion to Lebensphilosophie, was, during Scheler’s lifetime (Scheler died in 1928, Husserl in 1939), a sort of idealist, even a Platonist. Heidegger, for all his own obfuscations and denials, was a sort of Lebensphilosoph, even a realist (with his continual talk of beings partaking of Being), something that Scheler saw straightaway on being sent a copy of Sein und Zeit just before his death. Scheler himself avoided the one-sidedness of his colleagues by promoting a version of the human being which acknowledged both its animality and its spiritual dimension. The human being according to him was a precarious amalgam of Geist (spiritual and higher mental faculties) and Drang (a surging forward of life). As we said earlier, we find this notion compelling, as it allows for shifts in the balance between these two poles of the human being, which, as we shall see, are precisely what the schizophrenic and the depressive are.
Schelerian philosophy pertinent to delusion
There are several themes in Scheler’s philosophy, all unique to him, which inform the nature of delusion. We shall mention no less than six, a magnificent haul, which in itself justifies our choice of Scheler as mentor. We shall list them as follows in an order which reflects the dependence of each theme on the previous ones: (a) ontology constrained by epistemology; (b) multifarious knowledge; (c) existential relativity of ‘objects’ to knowledge; (d) overriding duality in humans of zufälliges Sosein (co-incidental nature of something) v Wesensein or Wassein (essence or basic nature of something); (e) essence as an amalgam of zufälliges Sosein and idea; and (f) phenomenological and Dionysian ‘reductions’ as thought experiments which tease out the limbs of the human duality – the human, imagined first as pure Geist, and then as pure Drang.
These critical notions are only found in Scheler’s late work: ‘Idealism and realism’ (Scheler, 1927/1973), ‘Erkenntnis und Arbeit’ (Scheler, 1926) and The Constitution of the Human Being (Scheler, 1979/2008). We shall indicate the general relevance for delusion of each notion as we proceed through the list.
(a) Ontology constrained by epistemology
‘Only the what of the being, not the being of the what, is intelligible’ (Scheler, 1927/1973: 312). In other words, any experience whatsoever is merely what we know, and the real ‘thing-in-itself’ which gives rise to this is beyond our ken. (This allows for a variable world of ‘objects’, including delusion, if the mode of knowledge alters.)
(b) Multifarious knowledge
Scheler referred to the ‘problem of spheres of being’ at three points in his late works. In Idealism and realism (Scheler, 1927/1973: 300), for example, he nominates eight: absolute (the origin of everything that is), external world, internal world, creature (as animal subject), environment (as object of animality), I, thou, and society. We do not propose to gloss all these, except to point out for our purposes that each realm commands its own sort of knowledge.(This sets the scene for the subversion by a variety of sorts of knowledge, which we concluded earlier was the basis for a delusional version of the world.)
(c) Existential relativity of ‘objects’ to knowledge
The same entity, the sun for example, can be the focus of different sorts of knowledge, and give rise to a different sort of experience in each case (Scheler, 1927/1973: 303). To a person surveying the horizon in the evening, the sun is a disappearing ball; to a scientist it neither disappears and nor is it a ball. Every entity can be experienced in several ways depending on how it is known. (We now have a more specific philosophical underpinning for our epistemic-ontological formulation of delusion, in the form of a rule that any individual’s experience of anything is merely one of several contending candidates. An x could easily be experienced as a y if a different sort of knowledge were trained on it.)
(d) Overriding duality of zufälliges Sosein v Wesensein or Wassein
There is overriding duality in human beings – overriding and encompassing the multifarious knowledge referred to – between two sorts of knowledge and hence experience that they can have of anything. The non-human animal only knows something as a ‘this or something else, not what it actually is’ (Scheler, 1926: 282). Its knowledge only goes as far as picking up what Scheler called something’s zufälliges Sosein, its accidental or co-incidental nature – being here now, with a particular value for its creaturely survival. The human being, on the other hand, is possessed of spiritual and higher mental faculties which enable it to stand back from its living concerns and grasp as well the very essential nature of something – its Wassein or Wesensein – e.g. a chair as a chair as well as something comfortable to sit on. (This insight into the human being, part animal and part spirit, offers, as virtually no other philosopher ever did, a window on the potential for delusion – a fragile accommodation between two ‘takes’ on the world, which, as we shall see in the case of schizophrenic and depressive delusions, can collapse into a one-sided perspective.)
(e) Essence as amalgam of zufälliges Sosein and idea
We now home in on the nitty-gritty of actual experience. Contrary to what Aristotle thought, an idea of something is not intrinsic to that something waiting to be actualized (Scheler, 1979/2008: 408), but nor is it, as Plato thought (Scheler, 1979/2008: 80–1), already present in ethereal form waiting to be realized as some attenuated example. The idea, Scheler says, is a ‘sketch’ (Skizze), which may or may not ever be realized, but if a real situation arises which renders the idea appropriate the idea will meld with the imagistic elements in any accidental situation (Scheler calls these ur-phenomena, e.g. the particular shade of red of a cherry) to produce the general notion of something, e.g. the essence of redness. Moreover, at the point when something is experienced, the idea and the ur-phenomenon coalesce such that the essence and its coincidental qualities are grasped simultaneously. The essence, he says, is immanent to the experience, neither an afterthought nor some prenatal collective unconscious. The idea has been building up since childhood based on the accumulation of like experiences, but the essence which such an idea helps to provide is always there in the experience, and is triggered only by the circumstances confronting us. Experience is always a whatness or essence grasped simultaneously with its zufälliges properties. (This ‘normal’ state of affairs, it seems to us, is a coalescence of two components, the relative contributions of which could be compromised. Scheler made no comment to this effect, but we consider that this allows a scenario whereby, if one or other were attenuated relative to the other, the actual experience of the world would be more or less essential, and less or more co-incidental and meaningless, precisely what we maintain is happening in schizophrenic and depressive delusions; see below.)
(f) Phenomenological and Dionysian reductions
Scheler’s thought experiments (Scheler, 1979/2008: 77–86, 99–103, 111–13, 402–3) are imagined scenarios of what a human being would be like if: (i) its animality (Drang) were wiped out (phenomenological reduction); and (ii) its spiritual nature (Geist) were cancelled out (Dionysian reduction).
What would remain in a ‘phenomenologically reduced’ human being would comprise all those faculties and mental paraphernalia unique to Geist, above all ideas and their objective correlate, meaning. The ‘phenomenologically reduced’ human would be a person governed by ideas – shorn of pragmatic relevance because Geist’s partner Drang and its practical concerns are no longer in contention to realize them – and subtending a world replete with free-floating meaning – whose provenance the subject would find puzzling because this too would be divorced from the hurly-burly of life that is Drang’s province. Not only this, Scheler made a critical advance over the version of the phenomenological reduction introduced by Husserl – merely a lame idealist supposition that the mind, not ‘reality’, determined the layout of the world, a world which was nevertheless identical to the world which the realist thought some ‘real’ concatenation of factors underpinned. No, what Scheler realized was that all sorts of major differences in the quality of experience would ensue if Drang (animality, but also responsible for the sense of aliveness, and for the experience of resistance which was the only way anything real could be adjudged to be real) were struck out.
Scheler imagines at least a dozen major consequences to the overall situation in this context, in addition to an overdetermination of a subject’s life by ideas and the pervasive atmosphere of meaning subtended by them. We shall list the following, which, as we shall see, are relevant to the construction of the schizophrenic’s world.
Adynamic world:
There disappear all causal interconnections because reality itself is the basis of all such causes. The result of this is that the reduced world is a perfectly adynamic world – nothing has an effect on anything else any more. [So, a world frozen in time, because nothing causes anything to move.] (Scheler, 1979/2008: 78)
Abolition of accidental being:
If the giveness of reality is abolished, with it is also abolished the whole realm of accidental such-and-such … leaving nothing but the pure and typical essences of things. [So everything is experienced as if some thing is a pure exemplar of its nature.] (p. 80)
Free-floating qualities:
For that aspect of reality on which the vital drive-based attention is directed is only on those qualities which can act as signs … of use to an organism … On the extent to which the reality factor disappears there then grows in meaningfulness an ever intuitively given fullness of qualities. [If the quality green is no longer a sign of lushness in potentially edible material, the green ‘takes off’ as it were as a free-floating quality.] (p. 82)
Acts no longer mine:
There is a shift in the status of my act of thinking … whereby it becomes … an act within the realm of absolute being … The sovereignty of this act, previously mine, now becomes completely under the aegis of God. [‘Myness’ disappears as an attached quality to anything I do, and is replaced by a sense that I am another’s agent, God’s for example.] (p. 103)
Disappearance of singularity:
There then disappears … the principle of singularization … with the fading away of the reality factor … all that is left in the residuum are pure essences … Forms, whose natural character have been limited … become in the reduced world independent objects – and known through intuitive knowledge and not sensory knowledge – and each then exists as a one-off version of a pure essence. [Everything is experienced as an actualized essence, i.e. typical of the class to which its heretofore zufälliges member had been much more diverse in form.] (pp. 78, 83; original italics)
Breakdown in natural order of preferred meanings:
The realm of meanings itself, whose subjective correlate is human thinking, is no less perspectival than the contents of intuition … From amongst the myriad meanings of things, our understanding extracts only that tiny fraction which is appropriate to the cultural and historical norms of our natural world-view. For example, as a European in 1922 the natural meaning of that black, longish thing over there is ‘umbrella’ … The reduction affects and distorts the ‘natural’ tendency in the following four respects … a) the emergence of constant images and therefore simple objective ‘urqualities’, e.g. red, blue, sour, sweet … b) the preference for regularity in any sort of happening … c) the overall trend in the natural view to interpret the world in quantitative terms, and d) the tendency for the phenomenon of movement to be preferentially experienced at the expense of an alteration in state … and a further tendency for the alteration of one form to be preferred over complete transformation of that form. [In the reduction, therefore, experience tends to be inconstant, complex, irregular, qualitative, static and metamorphosing.] (pp. 84–5; original italics)
Actualized sensations:
Our definition of sensation has a strange paradox … we could only experience a sensation were we dead, could never have it when alive. Sensation is an artificial construction of an organism comprising pure spirit. [A living organism never experiences sensations. Only a reduced human being, shorn of its animality and considered as pure Geist, could have sensations.] (Scheler, 1926: 407–9)
Multiplicity of individual worlds:
When life and its here-now characteristics fail, the individual centre at the root of the mind does not correspondingly fail. In fact the very opposite occurs: the reduction isolates and purifies this mental centre from its erstwhile links with life …. The reduced world is therefore a personal-individual world although part of God’s world too. Between three people – A, B and C – on whom the reduction has been carried out, this new world of theirs is mutually incomprehensible because it is ontically different one from another; this is in complete contrast to the generally valid, i.e. interpersonally comprehensible environmental world. The reduction leads to absolute being but also to a multiplicity of individual worlds. [The world subtended by a person deemed pure spirit is unique and incomprehensible both to other such spiritual persons and to other normal people still attached to their animality.] (Scheler, 1979/2008: 111; original italics)
Enhanced objectivization:
That part of us called Leib – the animality of us – is switched off, and by a certain process it then becomes objectified, and what is objectified is all that which is vital or soul-like about us … I now am a geistiger Person – a person with only mental, intellectual or spiritual dimensions and consider myself merely to have or possess or dominate my animality. [What was alive about the human being is no longer experienced in this way but objectified in the form of an inanimate thing.] (p. 112)
Abolition of empathic understanding:
There is a switching off of our sense of cohesion with other human beings, at least in the sense that these are living beings like us. All social convention, even those which underlie our language and the mutual understandings between people, are shut off … All preconceptions of a social or historical nature are also swept aside in the elevation of all things mental. [Each human being is truly, not metaphorically as the poet said, an island, devoid of empathy and no longer party or privy to linguistic and other conventions.] (p. 112)
God ‘switched on’:
The idea of God remains, and, as essence and existence of something of this essence are necessarily one in this realm, God cannot be put out of the question. In fact, God must be switched on, not switched off – i.e. a godliness will pervade all issues in the reduced world. [The new situation is that of an individual isolated from other human beings but embroiled in God and religiosity as no one in any natural way of being human ever was before.] (p. 113; original italics)
The Dionysian reduction (p. 402), wiping out what the phenomenological reduction preserved and preserving what the phenomenological reduction wiped out, imagines a purely creaturely environment in place of the normal human being’s status as part-animal, part-mind/spirit:
The Dionysian reduction, known to Schopenhauer and Bergson, involves the following (p. 402).
There is a switching off of mind, intellect and the experienced sense of the primacy of perception.
There is a coming to the fore of sympathy, animal sexuality and the imaginal portrayal of the world drawn from the forces of nature and life’s drives
Our participation in all this is not objectified [i.e. none of this is experienced as things or qualities of things].
There is an enhanced awareness of the historical dimension of mankind and a heightened sense of being part of nature.
The artistic in the human is at the forefront.
The power of instinct is to the fore.
In respect of the integration of the reductions with the metaphysics of the absolute the following remarks are pertinent. The following, however, concern only the Dionysian.
All images are expressive.
Life is experienced physiognomically [i.e. as if everything were a face].
The predominant mode of knowledge is through sympathy.
Everything here stems from the sexual drive of the human,
In place of the now switched off mental apparatus of the human there is an intuitive sense of participating in everything to do with the life-force: a ‘co-striving a ‘co-feeling’ and a ‘co-urgency’.
Schizophrenic delusions from a Schelerian perspective
Schizophrenic delusions, protean though they may be, do exhibit a set of themes, some of which Kurt Schneider (1939) accorded diagnostic status. What is striking about these themes, shown in Table 1, is their uncanny resemblance to the sorts of distortions in human experience which Scheler worked out in his thought experiment of phenomenological reduction. Yet other of Scheler’s insights in this respect illuminate non-delusional features of schizophrenic psychopathology (also shown in Table 1) which no previous psychopathological theorizing has got to grips with. We shall consider these correspondences in turn, only briefly mentioning the non-delusional psychopatho-logy. We shall also consider the implications for the various epistemo-ontological theses which we outlined earlier.
Schizophrenic psychopathology as aspects of Scheler’s phenomenological reduction.
(a) Delusions of control is the generic term in the English literature referring to a number of delusions and experiences in which, as Kurt Schneider (1962: 134) wrote: ‘appeared to emanate from an undue porousness of the I-world boundaries‘. Schneider himself was reluctant to be drawn into theoretical discussions as to their nature, while subsequent psychopathologists (e.g. Sims, 1991; Stanghellini, 2004) have been quite confident that a disturbance in myness, referred to in German as Ichstörung or by the recently coined term ‘lack of ipseity’, underpins them. Why this should be so has never been addressed, whereas Scheler’s conceit of a shift from animality to spiritual concerns and what this would entail for a being’s status and experience provides the first plausible account: there would be a renunciation of the sovereignty of an act and hence it would no longer be deemed mine.
(b) Delusional perception, recognized time and time again as stemming from a gratuitous plethora of meanings, is still an enigma because the origin of such a state of affairs has never been satisfactorily accounted for. Matussek (1952/1987) got close, in our view, with his appreciation that there was both a breakdown in the previous rules which determined how meaning was achieved (Gestalt breakdown) and the elaboration of a new context of meaning (based on a tendency to see identity in what would previously have been mere similarity). Sass (1994: 106), too, in his profound discussion of the matter, got to the heart of the problem by noting: ‘The experience may thus be bound up with a feeling of doubledness, the sheer sense that this event is in certain respects a copy of some prototype.’ But, as with Ichstörung and delusions of control, why this should be was left in the air. Scheler’s thought experiment yet again provides an answer: the transformation of a human being from a creature comprising Geist (mind/spirit) and Drang (life in all its urgency) to one restricted to Geist would necessarily experience free-floating meanings and qualities divorced from their hitherto restricted role as signs of goods for life, and, as Sass realized, and Scheler further accounts for, if such meanings and qualities bore the stamp of prototypicality and essence, then no wonder a subject in this state would find his or her world so compelling and uncanny.
(c) Delusional misidentification, particularly of the Capgras variety which is virtually pathognomonic of schizophrenia in the absence of overt brain damage (Pauleikhoff, 1954), is at root a problem of registering uniqueness or singularity (Cutting, 1991; Margariti and Kontaxakis, 2006). It is not primarily to do with visual perception, as Ellis and Young (1990) thought, as why otherwise could it occur in blind subjects, as mentioned earlier, and the focus in the several sorts of non-Capgras varieties can be of matters which are not even perceived, such as World War I (Vié, 1944). More-over, the true person (e.g. spouse), compared with which the actual person in front of the subject is deemed to be a bogus look-alike, is often itself a multiple clone (as in the syndrome of subjective doubles; Christodoulou, 1978), which no purely psychological theory can get a handle on. Scheler’s insight, however, that a human being devoid of the psychic functions intrinsic to a general living being, but still with the mental faculties which anyway distinguishes it from any non-human animal, would lose the capacity to register singularity, and experience every object as a one-off (or multiplied, in this case) exemplar of an essence, fits the bill neatly. The identity of perceived husband now/here and true husband is denied because the true husband is something that can only be grasped through intuition, not sensory knowledge, and has anyway shifted in form to being something of a prototypical husband, not the Jim Smith in front of her.
(d) Bizarre delusions are defined in DSM-5 (APA, 2013: 91) as: clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences … e.g. the belief that an outside force has removed his or her internal organs and replaced them with someone else’s organs without leaving any wounds or scars.
They continue: ‘Delusions that express a loss of control over mind or body are generally considered to be bizarre: these include … thought withdrawal … thought insertion … delusions of control.’ We would not regard the latter group as ‘bizarre’, but the definition above this is good and would cover the schizophrenic patient’s delusion we quoted earlier. Accounts of why anyone should entertain such ideas are sparse in the literature. Stanghellini and Ballerini’s (2007) is the best as it demolishes the very notion of bizarreness by showing that subjects are merely responding to the new epistemo-ontological framework that confronts them with astute philosophical insights. We would go further and say that the very alteration in their Weltanschauung is accounted for by some combination of those elements, described in the phenomenological reduction, which ensue when the preferred meanings intrinsic to a living being’s situation are no longer in play, and others, hitherto inhibited, are allowed free rein.
(e) Technical delusions are those, well described by Hirjak and Fuchs (2010), in which the subject experiences himself or herself under the control of some inanimate object. The subjects may also experience themselves as machine-like, as de Haan and Fuchs (2010) also demonstrated. Both themes are part of a yet wider tendency in schizophrenia for what we here refer to as enhanced objectivization, first recognized by Minkowski (1927/1987) and named by him as morbid rationalization, although it is rather a morbid objectivization or morbid reification. It extends into all realms, subjective and objective, as if the entire human being were being shredded and parcelled out: ‘thoughts outside of myself like a piece of wood’ (Cutting, 1997: 342); ‘sensations in his eyelids (referring to Schreber’s psychosis) were anthropomorphized as well as substantialized, becoming little men’ (Sass, 1994: 92); ‘the patient’s sensation, feelings and emotions are turned into material objects localized in a particular part of her organic body or somewhere in the external world’ (Hirjak and Fuchs, 2010). Again we ask: how can this be so? Again Scheler (1979/2008: 112) has the answer. In the course of the thought experiment he called the phenomenological reduction, which we are claiming provides the in-vivo model for the schizophrenic experience, Leib (life and everything to do with it) is ‘switched-off’ and ‘it then becomes objectified and what is objectified is all that is vital or soul-like about us … I (read schizophrenic) am now a geistiger Person‘.
(f) Religious delusions (e.g. Meurice, 2002; Schreber, 1903/1988) are again of enigmatic origin by any other account, yet Scheler’s (1979/2008: 113) terse remark that ‘God must be switched on’ in the phenomenological reduction is in keeping with the other correspondences we have drawn attention to in our Schelerian interpretation of schizophrenic delusions. Why God must be ‘switched on’ is beyond the scope of this article.
(g)–(k) Anomalous experiences, some aspects of visual and auditory hallucinations, cenesthetic experiences, autism, and lack of empathy and formal thought disorder. These will be briefly considered as they deserve a separate article for the full relevance of Scheler’s phenomenological reduction model to be appreciated. Even a brief mention, however, should consolidate the value of the phenomenological reduction for schizophrenic psychopathology as a whole.
Anomalous experiences in schizophrenia are protean, but one common theme is a sense of lifelessness and stillness: ‘On the Underground all I could see were people in a car and they looked like ghosts, statues, monuments, dead people, as if cremated.’ (Cutting, 1997: 113). Theirs is an adynamic world.
One aspect of their auditory hallucinations studied by Nayani and David (1996) was the person whose voice they heard, which, regardless of the subjects’ age, sex, class or race, tended to be a middle-aged, middle-class, middle-England male. Why should this be so unless, as we might predict from the phenomenological reduction, there is an abolition of accidental being, and experience, whether based on a real external event or hallucinated, and a gravitation towards the prototype or essence of some class of event. The same applies to their visual hallucinations (Cutting, 1997: 93) which tend to be schematic versions of something denuded of individual variation.
Cenesthetic experiences, sometimes elevated to a subclass of schizophrenia itself (Jenkins and Röhricht, 2007), are simple bodily hallucinations – kicks, punches, burning feelings, etc. – which are rife in schizophrenics. No explanation for them has been suggested, whereas Scheler’s notion – not part of the extant versions of the phenomenological reduction, although he was planning a book on metaphysics before he died relatively young – of sensation as an artificial construct in the natural (or sane human being in our context), but actualized in an isolated spiritual being, again fits the bill. Only a person comprising Geist shorn of Drang can experience sensations, however much that seems paradoxical to someone brought up on conventional psychological thinking.
Schizophrenic autism (not Kanner’s variety) has been variously formulated since Bleuler’s (1911/1950) introduction of the term. Parnas and Bovet (1991) give a clear account of the history of the concept. Common to all formulations is the notion of divorce from the commonality of human intercourse, a state of affairs which Scheler clearly ascribes to a human being in the throes of a phenomenological reduction, and, furthermore, envisages such a state as subtending a unique world, immune from all others, schizophrenics and normals. The autistic state is indeed an individual world and the population of schizophrenics as a whole inhabit their own worlds.
Finally, lack of empathy, and the peculiar idiosyncratic use of language which characterizes formal thought disorder (neologisms, disregard for the pragmatic value of language, etc.), are also brought into the fold of the Schelerian phenomenological reduction as a model for schizophrenia, when one appreciates that in the course of this reduction all conventions, linguistic and otherwise, go by the board, as they are what binds the living community, and in the phenomenological reduction and in our extrapolation of this to schizophrenia, such rules are no longer in play.
(l) Status of the various epistemo-ontological theses regarding schizophrenic delusions in the light of the phenomenological reduction as model of schizophrenia. Hedenberg’s (1927) suggestion that schizophrenic delusion derived its compulsion from its metamorphosis from judgement into sensation is undermined by Scheler’s appreciation that sensations have no place whatsoever in the repertoire of a normal human being. The schizophrenic does have ‘sensations’, but that is because he or she is a relatively pure spiritual entity and his or her delusions and their sensations derive from the same process, Both are secondary to this, and one is not the cause of the other.
Spitzer’s (1990) proposal to the effect that the schizophrenic delusion resembles the sort of knowledge one has of one’s own internal world is even more dubious, as the internal world – e.g. thoughts and the subject who thinks them – is itself changed in the schizophrenic process and is not a beacon of certainty in all this.
Schizophrenic delusion as inappropriate scientific induction replacing everyday judgement is also an unpromising thesis in the light of the phenomenological reduction’s so far beneficial status in accounting for these. In fact, Scheler also described a ‘scientific reduction’, quite apart from the phenomenological or Dionysian ones (Scheler, 1979/2008: 401–2), and this does not tally at all well with schizophrenic delusion. The authors cited above, who thought that they could see a scientific attitude in the schizophrenic’s approach to all matters, were duped, in our view, by the common tendency in psychopathology to mistake cause for effect. The schizophrenic, as Stanghellini and Ballerini (2007) showed, is faced with the monumental task of putting sense to senseless experiences and applies philosophical, scientific and any other available sorts of knowledge to the task.
Schizophrenic delusion as religious faith is also shown up as a cause-and-effect muddle. Certainly schizophrenics exhibit religious delusions, but, like all their experiences and beliefs, they have very little to do with the religious life of a normal person. For example, whereas the normal religious person accepts and abides by a whole set of ancillary beliefs – miracles, obedience to someone else’s rules of life, belonging to God’s community – the schizophrenic has no access to this. He or she is rather someone who is a community of one, works out their own rules of life (as we saw earlier), and any meaningful coincidences that keep plaguing him or her are nothing like miracles.
The only extant epistemo-ontological thesis which is viable within the Schelerian phenomenological reduction as a model of schizophrenia is that which acknowledges morbid objectivization as at the core of its psychopathology. Not only was this attested to by Minkowski (1927/1987), Cutting (1999) and Hirjak and Fuchs, 2010), but Scheler’s phenomenological reduction as a model for schizophrenic delusion has the precise wherewithal to explain this.
Depressive delusions from a Schelerian perspective
Depressive delusions, far less protean in their thematic content than schizophrenic, have nevertheless been badly served by the continual assumptions that they are understandable and stem from low mood. The two predominant themes are set out in Table 2, along with two of the items in Scheler’s Dionysian reduction to which they bear a close resemblance.
Depressive psychopathology as aspects of Scheler’s Dionysian reduction.
What nihilistic delusions share, in our view, is the attenuation or abolition of the nature of something, not a complete unacknowledgement of the existence of something. In fact, in the series of Hecaen and Ajuriaguerra’s (1952: 271–82) depressives, admittedly with brain damage but whose delusions were quite typically nihilistic, they experienced the complete abolition of the nature of something which left the mere experience of a vague sensation or emotion: ‘Right forearm seems … as if it’s not there from the elbow, and in its place a feeling of uneasiness.’ ‘If I let my limbs fall on the right side I have the feeling that I’ve forgotten them. My right side is replaced by pain. The half corresponding to the world is abolished.’ ‘I feel as if I no longer have a right hand. I have a sense of oppression and pain.’ ‘It’s as if there was an emptiness vaguely on the right, that on the right side everything is far away and empty.’ (original italics)
In ‘functional’ series such as Cutting’s (1997: 258–9), what is striking is the attenuation of the nature or functional incompetence rather than any obliteration: ‘Heart slowing down; blood not circulating properly; blocked bowels.’; ‘I’m shrinking away; I have no eyes; I have no face; no back passage; no body; no hands.’; ‘Parts of body and brain have gone … no blood pressure; hardly any lungs.’
We suggest that such experiences are in-vivo examples of the dilapidation of the essence or whatness component in any experience – absolutely or relatively – leaving intact the other component of any experience: its zufälliges Sosein. This is most telling in the organic examples, who still have an emotional and spatial experience, of which its ‘functional’ cousin is a sort of forme-fruste. The assumptions that nihilistic delusions are secondary to a lowering of emotion, or that delusion in general, according to Freud, is a rational mechanism for averting emotional experience, are completely trumped here, as rationality is either replaced by emotion or its attenuation is accompanied by a bitter bewailing of its loss.
Delusion of guilt, which is again automatically assumed to be a consequence of low mood and low self-esteem, is, if we heed Scheler’s Dionysian reduction, actually the converse of this century-long assumption. The switching-off of Geist and rationality in the Dionysian reduction brings on an upsurge in sympathy for our fellow creatures – human and non-human. What else can explain such statements as these, as in Cutting’s (1997: 313–14) series: ‘Failed to help man on a park bench.’; ‘Might harm children; killed her father; cut up a worm and fed it to a sparrow.’; ‘People angry with him because he made a suggestion that he should give £5 a week to striking firemen and police.’
O’Connor and colleagues (2007: 49) referred to it as ‘the moral system on overdrive’, and Minkowski (1933/1970) long ago, and Tellenbach (1982/2012) and Kraus (1982) more recently, realized that the depressive was overly involved in the social situation of others. Scheler’s Dionysian reduction, however, offers a philosophical underpinning for all this, which no one so far has been able to provide.
Unlike the case of schizophrenia, to which a plethora of psychological and psychiatric notions adhere, the theoretical psychopathology of depression is under-subscribed. Perhaps for this reason there is less overt polarization between psychiatric and psychological approaches. This is not to say that differences of opinion do not exist, but what we maintain is that neither the cognitive (the mainstream psychological) nor the conventional psychiatric model of the classical depressive state of melancholia is correct. Furthermore, we can demonstrate that this is so by reference both to psychopathological facts and to Scheler’s philosophy – in this case his earlier work Formalismus (Scheler 1913–1916/1973) as well as the Dionysian reduction.
Schulte (1961), for example, formulated melancholia as Nicht-traurig-sein-können im Kern melancholischer Erlebens [not-to-be-able-to-be-sad as the core of the melancholic experience]. Taylor and Fink (2006: 15), in their book Melancholia, described the essence of the condition as ‘pervasive gloom’. So one psychiatrist says that melancholics essentially cannot be sad, and other distinguished psychiatrists say that they are pervasively and essentially so. How do we resolve this? First, only Schulte of the protagonists can explain the psychopathological fact that melancholics complain bitterly that they have lost their feelings of love for their family, and he actually reported a case who could not grieve or feel sad when someone close died while he, the patient, was ill, yet regained all these when he got better. A pervasive sadness would not explain this. Moreover, only Scheler’s theory of emotional levels, in Formalismus, can provide a philosophical explanation. Scheler (1913–1916/1973: 342) allocates sadness to the psychic level of emotion (below spiritual and above vital and sensory), in which position it has the status of a mental feeling as he says quite specifically that it is not part of the vital core of the human being. In this book (p. 108) he anyway allocates sorrow to the geistiger (spiritual) level. If the Dionysian reduction cancels out all mental faculties of the human being, and if melancholia is an in-vivo example of the Dionysian reduction, then melancholia involves an absence of sadness – Schulte right, Taylor and Fink wrong.
As for the cognitive psychological model of depression, which is to the effect that low mood stems from a faulty negative evaluation – i.e. a rational judgement – of one’s situation, which can further be corrected by guided positive rationalization, this fails to appreciate that the problem with depression – certainly melancholia, though not necessarily with a non-melancholic depression with which psychologists usually deal, but they never make this clear – is that the rationality of the human being is wiped out as part of the condition, and so neither the cause nor the treatment can be blithely assumed to be, respectively, faulty rationalization or its guided re-ordering.
Non-schizophrenic, non-affective delusions
We admit that our perspective on delusion is overwhelmingly concerned with schizophrenic and depressive varieties, and that a number of delusional states given syndromal status in the old literature – e.g. delusional parasitosis, erotomania, litigious paranoia – and subsumed under ‘delusional disorder’ in DSM-5 (APA, 2013), are not accommodated in our scheme. We believe that delusions are, in toto, heterogeneous and would allow other explanations for the non-schizophrenic, non-affective variety, not necessarily philosophical ones. In fact, we would suggest that these sort of delusions, rare relative to schizophrenic or depressive in the scheme of things (Winokur, 1977), may well be appropriately deemed of psychogenic origin, as in numerous twentieth-century accounts (e.g. Kretschmer 1918/1974; Lacan 1932/1987). We would further suggest that such cases have been inappropriately taken for models of all delusions.
Conclusions
This two-part article has challenged the contemporary mainstream view that delusions are psychologically explicable. It has reviewed the critical psychological literature and found it wanting when it comes to explaining both schizophrenic and depressive delusions. The psychiatric literature on the matter in the mid-decades of the twentieth century, by contrast, set out the problematic in a more profound way.
In the second part of the article we have applied the ideas of one of the original trio of phenomenological philosophers – Max Scheler – to schizophrenic and depressive delusions, and concluded that his thought experiments as to what a human being would be like, either shorn of their animality (Drang) or of their higher mind and spirit (Geist), provide a quite uncanny look-alike to schizophrenia and depressive psychosis, respectively.
