Edmund Husserl was a German philosopher whose work separates the wheat from the chaff, and I’m definitely the latter, knowing next to nothing. I once knew a philosophy professor who was an expert, but all I ever heard him talk about was Husserl’s life and relationship with his assistant, Martin Heidegger. One more story – my medical school friend was writing his thesis on Husserl in graduate school. Late one night, while reading Husserl, he said that he "sort of got it." He left graduate school that night and drove from Durham NC to Memphis TN where he registered for the premed courses he lacked. I’ve never heard him talk about philosophy in the half century I’ve known him since. Having thus established my non-credentials, a few days ago, I chased a Twitter link from Neuroskeptic that lead me to the article below from Heidelberg Germany – from the Departments of "Phenomenological Psychopathology and Psychotherapy" and the "Structural Neuroimaging Group" [an unusual grouping, to say the least]. If you watched the Ted Talk by Eleanor Longden [voices…] with as much wonder as I did, you might have the stomach to then wade through this article [way more than once] to follow the authors’ thinking, and the reason for bringing up Husserl will be a bit clearer:
by Dusan Hirjak, Thiemo Breyer, Philipp Arthur Thomann, and Thomas FuchsPLoS ONE. 2013 8[9]: e73662. doi:10.1371/journal.pone.0073662.
Objectives: In 1950, Kurt Schneider proposed that a considerable number of schizophrenia patients develop first-rank symptoms [FRS]. In such cases, patients report made experiences, replaced control of will, thought insertion, broadcast or withdrawal and delusional perception, respectively. Although a number of recent studies tend to explain FRS in terms of neurobiological and neuropsychological processes, the origin of these symptoms still remains unknown. In this paper, we explore the subjective experience of patients with the following two FRS: [1] "made" impulses and [2] “made" volitional acts.Method: The method applied for the study of two FRS consists first in the overview of psychiatric and philosophical literature and second in the further investigation of subjective experience in patients with FRS. Psychopathological and phenomenological aspects of FRS are discussed by means of patient cases.Results: We discovered a profound transformation of intentionality and agency in schizophrenia patients with body-affecting FRS. This concept offers an insight into the interrelatedness between particular FRS.Conclusion: We propose that the subjective experience of schizophrenia patients with body-affecting FRS is rooted in the disturbance of intentionality and diminished sense of agency. This theoretical account of body-affecting FRS will open up new directions in both phenomenological and neurobiological psychiatric research.
Kurt Schneider was a German psychiatrist in Heidelberg who focused on psychiatric diagnosis. While less well known than people like Emil Kraepelin, Sigmund Freud, Karl Jaspers, or Eugen Bleuler – his contributions were sizable and one was particularly impressive to me – his First Rank Symptoms of Schizophrenia. While they never made it into an official diagnostic manual, they made it into mine. They were:
- Auditory hallucinations
- Voices heard arguing or giving instructions [2nd person]
- Voices heard commenting on one’s actions [running commentary, usually describing the patient in the 3rd person]
- Somatic/thought passivity experiences [delusions of control / of being controlled]
- Thought echo [thoughts being heard aloud]
- Thought withdrawal
- Thought insertion [thoughts are ascribed to other people who are intruding into the patient’s mind]
- Thought broadcasting [also called thought diffusion]
- Delusional perception
I was particularly taken with the running commentary [that’s where Eleanor Longden’s troubles began]. You don’t often hear about it unless you ask, and in my experience, I’ve only seen it in the classic schizophrenic presentation [I’m aware that the term schizophrenia is unpopular in some circles and many see it as a false category these days, but I’m old, and classic schizophrenia remains an entity in my mind]. But back to the article, what I found fascinating was the idea that what was abnormal in their cases was an absence, an absent sense of agency and intentionality, basic building blocks in Husserl’s studies of the structure of human consciouness. It’s a different way of conceptualizing what’s going on that unifies the "thought disorder" and the psychotic experiences. It was intriguing to think about and a welcome relief from musing about the drug industry…
I’ve read recently in Benthal’s Doctoring the Mind that the primary difference between people who hear voices and aren’t disturbed by them and people who are overwhelmed by them is mostly a matter of feeling stronger or weaker, respectively.
It seems to me that that absence of agency and intentionality might be explained by a lack, imbalance, or force that prevents attachment, or forms an insecure attachment; or an imbalance of security/freedom that doesn’t allow a toddler to build self-confidence and learn skills, an emotionally imbalanced and/or environment in which a child cannot learn how to handle their emotions, etc.
The first three years are so vital. Perhaps one of the reasons that so many mental disturbances and neuroticisms seem not to make sense or not have evident causes is that none of us remember those first three years.
stronger or weaker than the voices
and or violent environment