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Existential feeling in schizophrenia 

Existential feeling in schizophrenia
Existential feeling in schizophrenia

Matthew Ratcliffe

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date: 21 August 2018

This chapter addresses the question of whether and to what extent altered experience and thought in schizophrenia are explicable in terms of existential feeling. The role of existential feeling in schizophrenia is difficult to assess, as the illness is divided into different ‘sub-types’ and, even within a sub-type, the balance of symptoms changes over time and varies from case to case. Depersonalization and the Capgras and Cotard delusions can all arise in schizophrenia. So an account of existential feeling in schizophrenia must be able to accommodate all three and a lot more besides. In what follows, I argue that many symptoms of schizophrenia are better understood if we abandon conceptions of experience that separate body from world, cognition from feeling and inside from outside. I begin by discussing the close connection between anomalous feeling and changed experience and thought in early descriptions of schizophrenia offered by Emil Kraepelin and Eugen Bleuler. Then, drawing on the more recent work of Louis Sass and others, I suggest that existential feeling is directly responsible for certain delusions and operates as an experiential background that is conducive to the formation of others. In so doing, I reject the distinction between ‘positive’ and ‘negative’ symptoms. Following this, I turn to disorganized thought and thought insertion. I propose that both originate in a variant of existential feeling that is characterized by a lack of temporal consistency. The chapter concludes by distinguishing some of the different existential feelings that feature in psychiatric illness more generally and by suggesting that distinctive kinds of existential feeling are unlikely to reliably match up with current diagnostic categories.

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