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Explaining schizophrenia: the relevance of phenomenology 

Explaining schizophrenia: the relevance of phenomenology
Chapter:
Explaining schizophrenia: the relevance of phenomenology
Author(s):

Louis A. Sass

and Josef Parnas

DOI:
10.1093/med/9780198526131.003.0004
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date: 16 February 2019

Is phenomenological psychopathology purely descriptive or can it also have explanatory relevance? This question is addressed in relation to schizophrenia and by focusing on a phenomenological account advocated by the present authors. In our view, schizophrenia is best understood as a disorder of consciousness and self-experience (disturbed ipseity) that involves two key aspects: hyper-reflexivity (forms of exaggerated and alienating self-consciousness) and diminished self-affection (a diminished sense of existing as a subject of awareness or agent of action).

After mentioning some prior views concerning phenomenological description or explanation and also mental causation, we outline several ways in which the subjective dimension of schizophrenia can be relevant for explanatory purposes. We distinguish two explanatory perspectives according to whether the relationships at issue apply to phenomena that occur simultaneously (the synchronic dimension) or in succession (the diachronic dimension). Within the first or synchronic realm, we discuss three kinds of relationship: equiprimordial, constitutive, and expressive—all of which involve not causation but a kind of phenomenological implication. Then we turn to the diachronic dimension. Here we consider primary, consequential, and compensatory processes. All three can play a role in a causal account of the development of schizophrenic symptoms over time.

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