[Structuralistic and meta-psychological approaches to ambivalence in schizophrenia].

The word "ambivalence" generally signifies a psychic state in which a subject holds a contradictory or conflicted attitude towards an object. The literal meaning of the word is that two valences occur simultaneously, and this connotes the epistemological and ethical problem of where and how the valences arise. The concept of ambivalence implies that the relationship between the subject and the world is ambivalent, that the subject has free will in the alternative evaluation, and that the meanings of the two valences derive from the meta-level outside the world. These reflections lead us to the supposition that ambivalence is closely associated with the function of language. The ambivalent attitude of the subject divides the significance of the object; the appearance of the given ambivalent meanings is the moment of the subject's choice. This phenomenon of division, choice, and given meanings is more than analogous to F. de Saussure's conception of language in terms of sign, différenciation, and l'arbitraire de langue. A view of ambivalence as a fundamental phenomenon concerning subject, world, and language affords insight specifically into ambivalence in schizophrenia. For people with schizophrenia, ambivalent conflict often takes the form of a dichotomy between "good and bad". The more severe the ambivalent symptom, the more similar it seems to a philosophical question about the nature of existence in the world. When schizophrenic people raise philosophical questions directly such as "Is my existence good or bad?" or "To be or not to be?", they seek approval for their existence, assaying to live with "good" intentions. Unfortunately they come to be blamed for harbouring "bad" intentions. When they have an interrogative attitude even to everyday matters, they cannot resolve such questions as "Is the red cup good or bad?", or "Is the green cup good or bad?", and hence "Which cup should I use?". If the projection of the self into the world is essentially the choice of a daily behavior as its own praxis, such indecisiveness thus entails existential conflict. The alternatives of choice appear before them as a tollgate to the world. Wishing admission to the world, they choose the thing that they think "good", but which later turns out to be "bad". These consequences sometimes occur in their inner conflicts and sometimes in their paranoidhallucinatory experiences. We have observed that in these processes, there is an inversion between "good and bad", and "bad" predominates, driving patients to despair. Rethinking E. Bleuler's conception of the ambivalence of schizophrenia, we have found that it is accessible to structuralistic and meta-psychological interpretations. From the viewpoint of linguistic semiology, ambivalence can be considered as a disorder of exclusive differentiation in the associative system resulting from the appearance of antithetical meanings, a phenomenon that is also common in primal words and children's thinking. In the context of psycho-analysis, it is suggested that the dominance of the negative side in ambivalence may be caused by death instinct. These interpretations are consistent with both the philosophical considerations and the clinical observations introduced above, but the problem of schizophrenic specificity is still opened beside the affinity between philosophical conflict and schizophrenic ambivalence. References to ethical and philosophical thinking shed light on the sources of the dichotomous existential conflict and the characteristic inversion between "good and bad" that schizophrenic patients experience. Descriptions of the root of ambivalence can be traced back to ancient times. In the Ecclesiastes of the Apocrypha, Jesus, son of Sirach, elucidates the fundamental ambivalence of will, teaching that the subject has the power of its own choice: at its most extreme, the choice between life and death. In the modern age, L. Wittgenstein offers a strict description of this ambivalence in his "Notebooks 1914-1916". Wittgenstein doubted the possibility of pure subjectivity without individual will and furthermore argued that the will is either good or evil, that is, the bearer of good and evil. In his view, good and evil are somehow connected with the meaning of the world, and meaning ("Sinn" in German) is discerned from significance ("Bedeutung" in German). He went on to write that the meaning does not lie in the world but outside it. As K. Shingu has noted, Wittgenstein's conception is essentially consistent with psycho-analysis. The subject recognizes the world with ambivalent will, the world appears with ambivalent significance, but its ambivalent meaning is given from outside the world, that is, from the meta-level. For E. Husserl's concept of intentionality, it is said that the fundamental disorder of schizophrenia is a preverbal or pre-predicative problem that is connected with intentionality. Yet one wonders whether or not pure, neutral intentionality is really possible. Presumably, intentionality has an intrinsic ambivalence, since the fundamental relationship between the subject and the world may itself be ambivalent. When one becomes conscious of a thing, the potential exists to divide one's intentionality between "good and bad", and the thing thus appears as "good" or "bad". In the healthy psyche, this intrinsic ambivalence emerges only in ethical or philosophical thinking. In schizophrenia, however, the ambivalence of intentionality is explicitly engaged in diverse situations. The inversion of "good and bad" observed in the clinical context signifies that the will of the patient shifts from "good" to "bad", alluding to a contradiction between the subject and the world that is logically inevitable due to the structure of their relationship. The subject objectivfies the world positively, yet is contained by the world passively. That the subject simultaneously announces and is announced in the language system also reflects this paradoxical relationship. Thus, ambivalence of dichotomy between "good and bad" is the very basic phenomenon of consciousness, and the inversion of "good and bad" is a reflection of the structure of the relationship of the subject and the world. If the schizophrenic specificity exists, it may involve the exposure of this intrinsic ambivalence and this paradoxical structure in confrontations with the tellgate into the world under the dominance of the negative side.