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Sass - Heidegger Schizophrenia and the Ontological Difference

Sass - Heidegger Schizophrenia and the Ontological Difference

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Published by: Philip Reynor Jr. on Aug 31, 2011
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HEIDEGGER, SCHIZOPHRENIA AND THE ONTOLOGICAL DIFFERENCEL. A. Sass (1992) Philosophical Psychology Vol.5, Issue 2.
ABSTRACT: This paper offers a phenomenological or hermeneutic reading--employing Heidegger's notion of the `ontological difference'--of certaincentral aspects of schizophrenic experience. The main focus is on signs andsymptoms that have traditionally been taken to indicate either poor reality-testing' or else 'poverty of content of speech' (defined in the Diagnostic andStatistical Manual of Mental Disorders III-R as "speech that is adequate inamount but conveys little information because of vagueness, emptyrepetitions, or use of stereotyped or obscure phrases"). I argue that, at leastin some cases, the tendency to attribute these signs of illness to theschizophrenic patient results from a failure to recognize that such patients--as part of a quasi-solipsistic orientation and alienation from more normal,pragmatic concerns--may be grappling with issues of what Heidegger wouldcall an ontological rather than an ontic type, issues concerned not withentities but with Being (i.e. not with objects in the world but with the overallstatus of the world itself5). An application of the Heideggerian concept of theontological difference has the potential to alter one's sense of the lived-worlds of such patients, of what they may be attempting to communicate,and of why communication with them so often breaks down.
Perhaps the greatest challenge for the psychotherapist is the establishmentof a therapeutic relationship with the schizophrenic patient
. This difficultyhas a number of sources, but chief among them is that of communicatingwith a person who inhabits a world radically alien to that of common sense. Itis true that, by definition, all psychoses involve disturbed judgement andacceptance of some kind of altered reality. In the case of the other'functional' psychoses (manic-depressive illness and pure paranoia), however,the prominent symptoms tend to involve beliefs or experiences that couldoccur in real life or that can at least be comprehended as exaggerations of normal fears and fantasies--as, for example, when patients have thoughts of being followed or poisoned or admired by multitudes (American PsychiatricAssociation, 1987, p. 202). Only the delusions and hallucinations of theschizophrenic can be said to be (in Karl Jaspers's words) "mad in the literalsense" Jaspers, 1963, p. 577), that is, to concern situations that are not onlyfalse but virtually inconceivable or incomprehensible because they implyalterations in the most fundamental structures of time, space, causality, orhuman identity. Thus schizophrenic delusions will often involve cosmic ornihilistic fantasies that can only be described as bizarre: the patient mayclaim, for instance, that everyone else in the world is but an automatondevoid of human consciousness; that the entire universe is on the verge of dissolution; that all the clocks in the world feel the patient's pulse; or that
Based on a paper delivered at the 'Applied Heidegger' conference, University of California atBerkeley, September 1989.
when his eyes get bright blue, the sky also turns blue (Jaspers, 1963, p.296)
. The sheer fact of strangeness is, in fact, enshrined at the very center of diagnostic practice. In the latest American diagnostic manual, delusionsidentified as 'bizarre' are considered to be especially suggestive of aschizophrenic type of psychosis; while European psychiatry has long beeninfluenced by the views of Jaspers, who believed that the most accurateindicator of schizophrenia was the feeling of alienness evoked by suchpatients: namely, the interviewer's intuitive but unmistakable sense of encountering someone who, in the words of the Swiss psychiatrist ManfredBlenler, is "totally strange, puzzling, inconceivable, uncanny, and incapable of empathy, even to the point of being sinister and frightening" (M. Bleuler,1978, p. 15). Schizophrenics are, in fact, perhaps the clearest illustration of that incomprehensibility which, according to Wittgenstein, can occur betweenpersons who may share a language but not a single "form of life":One human being can be a complete enigma to another. We learn this whenwe come into a strange country with entirely strange traditions; and, what ismore, even given a mastery of the country's language. We do not understandthe people. (And not because of not knowing what they are saying tothemselves.) We cannot find our feet with them. (Wittgenstein, 1953, p. 223)In the present essay I hope to provide a Heideggerian reading that shouldhelp us to find our feet, allowing us to illuminate the phenomenology of atleast some instances of this supposedly incomprehensible condition as wellas to understand why it should pose such a challenge to hermeneuticunderstanding. (I don't claim, incidentally, that my reading is necessarilyrelevant to all patients diagnosed as schizophrenic.
) The aspects of schizophrenia on which I shall focus are two: the first, concerning the form orstructure of the experiential world, is the nature of their characteristicdelusions, a topic I have already introduced. The second bears more directlyon the problem of communication, and this is the presence in their speech of what is frequently called 'poverty of content'. This quality, found in somestudies to be the single most distinctive feature of schizophrenic language,involves speech that is adequate or normal in quantity and pace, but thatappears to convey little information because it seems "vague, overly abstractor overly concrete, repetitive, and stereotyped" or because it sounds to thelistener like "empty philosophizing" (American Psychiatric Association, 1987,pp. 188, 403; Andreasen, 1986, p. 475; also see Andreasen, 1979, p. 1327).Often such speech is taken to reflect a quality of 'vague wooliness' in thethinking that underlies it, or the presence of a 'murky', 'undifferentiated' and
 Jaspers describes schizophrenia in its initial stages as often involving "cosmic, religious or metaphysical revelation"; quoted in cutting, 1985, p. 30.
The interpretation I am offering might best be thought of as a kind of ideal-type analysis. The patients to whom it is most applicable would fall into the schizophrenia category in theDiagnostic and Statistical Manual of Mental Disorders III-R (DSM III-R) (though it may not apply to all such patients). I will not concern myself here with certain transitional types, e.g. theschizoaffective and schizophreniform categories.
homogenizing mode of cognition.
(one Russian investigation found that 54%of schizophrenics studied had a tendency toward "fruitless intellectualizing,philosophizing, and pseudo-abstract reasoning" [Gabriel, 1974, cited inOstwald & Zavarin, 1980, p. 75].
) A good example is the following statementby a schizophrenic, which I will return to later in this essay. After an initialcryptic phrase, the patient continues in the sort of vein that is likely to bedismissed as pseudo-philosophizing, as a case of vague or even emptyverbiage:Chirps in a box. If you abstract yourself far enough from a given context youseem somehow to create a new kind of concretion It isn't something youhave or see but yet somehow. It's being fascinated by the generative processof the mind. The thing is to be caught in it, yet abstract from it. Both be in itand out of it--revolving everything around me. (Lorenz, 1961, p. 604).
 The aspect of Heidegger with which I shall be concerned is that of the famous`ontological difference'. This phrase refers to an issue that is easy enough tostate but exceedingly difficult to explain: the, in Heidegger's view, all-important yet easily forgotten distinction between entities and their presenceas entities, or between what he calls beings and Being, the latter of whichmight be spelled with a capital B. Though not always labelled as such,ontological difference--which the later Heidegger referred to as simply "thedifference"--is probably the most central theme running through the entirecorpus of his writings. While there can be no possibility here of expoundingall its nuances, ramifications, and possible contradictions, we do need toconsider its basic meaning and certain of its ambiguities before we can use itto understand schizophrenia.
In Being and Time (1962,originally published 1927), the major work of his firstperiod, Heidegger distinguishes between two domains of inquiry that helabels the "ontological" and the "ontic"--terms he leaves undefined but whichhis translators gloss as referring, in the first instance, primarily to Being andin the second to "entities and the facts about them" (Heidegger, 1962, p. 31,fn.). Being, at least at this stage of Heidegger's work, refers largely to thecontext or mode of being, what he describes as the all-inclusive but, for this
Re 'wooliness', see, e.g. Wing (1981, p. 121). Millon (1981, p. 295) describes murky and undifferentiated modes of cognition; note, however, that he is referring to the schizoid  personality, the character type most commonly found as a precursor to schizophrenia. Thesupposedly undifferentiated nature of the schizophrenic's cognition is often asserted; e.g.Searles (1965).
 As Ostwald & Zavarin suggest, however, these Russian findings may be tainted by the natureof the sample of 'schizophrenics': the diagnosis of 'sluggish schizophrenia' was sometimesapplied in the Soviet Union to intellectuals and political dissidents.
For a more confusing (and confused) speech sample which also illustrates the abstract and reflexive quality of schizophrenic speech, see Arieti, 1974, p. 265.

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