Henriksen Mads Gram, Nilsson Lars Siersbæk
Mental Health Center Glostrup, University Hospital of Copenhagen, Broendby, Denmark.
Psychopathology. 2017;50(5):321-333. doi: 10.1159/000479702. Epub 2017 Sep 27.
Recent studies in phenomenological psychopathology emphasize the importance of intersubjectivity for our understanding of schizophrenia. Yet, the central role of the "we" in social experience and engagement is largely absent from this literature. Our study explores the relation between psychopathology and intersubjectivity in the schizophrenia spectrum through the prism of the "we." First, we explore the role of intersubjectivity in the current schizophrenia spectrum definitions and discuss the main contemporary research trends. Second, we recollect some of the classical accounts of schizophrenia, which offer a different perspective on the pervasive and often persistent intersubjective difficulties in these conditions. Third, capitalizing on recent advances in collective intentionality studies, we present and discuss a conceptual framework of the "we" and of how the "we" may be disrupted in schizophrenia. Through this framework and with the use of clinical vignettes, we elicit 3 compensatory strategies, which, we suggest, reflect a fragile sense of "we" in the schizophrenia spectrum, i.e. (i) positive withdrawal, (ii) imposing a goal-oriented, spatiotemporal structure on intersubjective engagement, and (iii) preferring social activities with a clear attribution of social roles and rules. Finally, we discuss the relation between anomalous self-experiences (i.e. self-disorders) and the complicated "we."
近期现象学精神病理学研究强调主体间性对于我们理解精神分裂症的重要性。然而，该文献中很大程度上缺失了“我们”在社会体验与参与中的核心作用。我们的研究通过“我们”这一视角，探讨精神分裂症谱系中精神病理学与主体间性的关系。首先，我们探究主体间性在当前精神分裂症谱系定义中的作用，并讨论当代主要的研究趋势。其次，我们回顾一些关于精神分裂症的经典论述，这些论述为这些情况下普遍且常常持续存在的主体间性困难提供了不同的视角。第三，利用集体意向性研究的最新进展，我们提出并讨论“我们”的概念框架以及“我们”在精神分裂症中可能如何被扰乱。通过这个框架并借助临床案例，我们引出三种补偿策略，我们认为这些策略反映了精神分裂症谱系中脆弱的“我们”感，即：（i）积极退缩，（ii）在主体间参与中强加一个目标导向的时空结构，以及（iii）偏好具有明确社会角色和规则归属的社交活动。最后，我们讨论异常自我体验（即自我障碍）与复杂的“我们”之间的关系。
