Delusion and Reason: An Argument for a Phenomenological Model for Understanding Schizophrenic Delusion

This article by Gert Jensen, published in the Schizophrenia Bulletin, includes a very illuminating first-hand account of the subjective, lived experience of what is called ‘schizophrenia’. The article begins:

“The nature of some schizophrenic delusions seems distinct from delusions present in other psychotic disorders.1–4 In some psychological and neurocognitive research, one proposal for understanding delusion is the so-called two-factor theories of delusion.5–7 Briefly, two-factor theories of delusion propose that delusion stems from an anomalous experience (the first factor) and a failure of reasoning (the second factor).

In this article, I argue that two-factors theories are critically lacking in their understanding of how reasoning and anomalous experiences affect each other in schizophrenia, and, moreover, that Bleuler’s8 concept of double-bookkeeping may prove helpful grasping for this complex relation. I suggest that a more nuanced understanding of the first factor (ie, the nature of anomalous experiences in schizophrenia) is all that is needed to understand delusion, rendering the second factor superfluous. More than this, I suggest that there is no failure of reasoning, and eventually that the two-factor theory should be discarded. I will also suggest that a phenomenological model of delusion, as recently proposed in Feyaerts et al1, is relevant for understanding the qualitative shifts in subjectivity, which one experiences when undergoing a delusional state, and that such an understanding is essential to adequately understand schizophrenic delusion.

I start with an autobiographic note. I am myself diagnosed with schizophrenia, and in periods I suffer from strange, bizarre, and anomalous experiences. This can be anything from an unsettling feeling of ‘oddness’ just beneath the surface of the “perceived” world, an experience of a parallel ‘other’ world that influences the ‘normal’ perceived world, to full-blown delusions or auditory, tactile, or visual hallucinations. While it is somewhat rare that I experience full-blown psychotic symptoms, the experience of a presence of something ‘otherly’ and bizarre as well as the experience of two parallel and sometimes conflicting realities are more common. In my experience, the sense of another reality is often a factor that is coupled with the emergence of delusions …”

You can read more from here.

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