Parnas and Sass / SELF, SOLIPSISM, AND SCHIZOPHRENIC DELUSIONS
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Self, Solipsism, and Schizophrenic Delusions Josef Parnas and Louis A. Sass
ABSTRACT: We propose that typical schizophrenic delusions develop on the background of preexisting anomalies of self-experience. We argue that disorders of the Self represent the experiential core clinical phenomena of schizophrenia, as was already suggested by the founders of the concept of schizophrenia and elaborated in the phenomenological psychiatric tradition. The article provides detailed descriptions of the prepsychotic or schizotypal anomalies of self-experience, often illustrated through clinical vignettes. We argue that delusional transformation in the evolution of schizophrenic psychosis reflects a global reorganization of consciousness and existential reorientation, both of which radiate from a fundamental alteration of the Self. We critically address the contemporary cognitive approaches to delusion formation, often finding them inconsistent with the clinical features of schizophrenia or implausible from a phenomenological point of view. KEYWORDS: self-awareness, subjective experience, preschizophrenic prodrome, phenomenology, psychosis, cognitivism The greatest hazard of all, losing one’s self, can occur very quietly in the world, as if it was nothing at all. No other loss can occur so quietly; any other loss—an arm, a leg, five dollars, a wife etc.—is sure to be noticed. —Søren Kierkegaard
© 2002 by The Johns Hopkins University Press
1. Introduction
T
HE ARGUMENT OF this paper, based on em-
pirical research, clinical experience, and phenomenological considerations, is that disorders of the Self represent the psychopathological core of schizophrenia. The notion of “core” refers to a basic, generative disorder (“trouble générateur”: Minkowski 1997), clinically detectable in the pre-illness stages and operative in the formation of the schizophrenic psychosis as its underpinning, and lending coherence to the various symptoms of the advanced stage (e.g., delusions). In our view, the emergence of delusions in schizophrenia cannot be comprehended as an effect of a modular dysfunction in the chain of “information-processing,” but should, rather, be seen as an instance of a quite profound Self-World transformation, as a construction of a “delusional world” reflective of a solipsistic position inchoate in the pre-onset or prodromal stages of the illness.1 These views can be accommodated within a framework of the so-