SCHIZOPHRENIC DELUSIONS - A PHENOMENOLOGICAL APPROACH

The issue of specificity of delusions in schizophrenia is still a matt er of debate. The authors analyze the delusion formation in schizophre nia from a prototypical, phenomenological point of view, focusing on t he subject's experience. This perspective links delusion formation to the autistic predisposition, which is considered here as the elementar y phenotypic expression of the vulnerability to schizophrenia. Autism is viewed as a defective preconceptual (i.e., before language) attunem ent to the world. It impedes the individual's sharing of ''common sens e'' with others and impairs the ability to project into the future. Th e development of delusions is illustrated, in part, by Klaus Conrad's work on the onset of paranoid schizophrenia. Delusions are viewed as t ransformations of the structure of experiencing. When threatened in fu ture ability to be, the autistic, vulnerable person looks for the clue s to becoming by attributing significance to disparate elements of the environment, which become self-referential. The link established betw een these disparate elements is based on universal characteristics tha t give the schizophrenic delusion a metaphysical quality. The transiti vistic experience in delusions of control and omnipotence points to a specific way of crossing the border between ''mine'' and ''yours'' (di sturbances of the experiencing ''I''). What strikes a clinician in the se delusions is that the normally tacit link between the sense of bein g and the sense of acting becomes quite apparent. The authors also pro pose a specificity in the themes of schizophrenic delusions. Delusions acquire a schizophrenic quality when ontological (i.e., universal) el ements of the discourse between the locator and the Other dominate at the expense of the worldly elements. It is emphasized that delusional content and form are dialectically related and hardly distinguishable. The authors consider the delusion formation as a phenomenon of emerge nce, a situation in which a new qualitative order arises from the reor ganization of essentially unchanged elements. To consider schizophreni a as an emergent, particular way of experiencing, related to the autis tic defect, has important consequences for research and for treatment. A dialectic exchange is needed between prototypical models generated by phenomenological inquiry and empirical, operational validation of t estable aspects of such models.