Holm-Hadulla R
Psychiatrische Universitätsklinik Heidelberg.
Fortschr Neurol Psychiatr. 1988 Jan;56(1):1-7. doi: 10.1055/s-2007-1001212.
This study originated from a phenomenological and speech-act theoretical concept of schizophrenic concretism. An experimental study was performed showing a highly significant lack in the schizophrenic patients' ability to use metaphors correctly. Basing on the interpretation of proverbs, the hypothesis is rejected that false interpretations of schizophrenic patients are due to intermingling of personal conflicts. On the other hand, it could be shown that concretistic interpretations of proverbs represent an avoidance of conflicts. The concepts of "substitution" and "transfer" enabled us to measure pathological concreteness and "deconflictualisation". The differentiation between schizophrenic and nonpsychotic patients was found to be highly significant. In a complementary study it could be shown that the chronic schizophrenics' disability to transfer images of proverbs to an interpersonally relevant context does not differ significantly from that of patients with their first schizophrenic episode. Discussing our empirical findings, we try to show that the concretistic reduction of thought and speech is also a paradigma of delusion. The "incorrigibility" of schizophrenic delusion was seen to be based on reification of verbal signs and metaphors. After trying to show a connection between the concretistic "Lebensform" (Wittgenstein) and the disordered intentionality of schizophrenic patients, pointers towards psychotherapeutic implications are given.
本研究源于精神分裂症具体性的现象学和言语行为理论概念。一项实验研究表明,精神分裂症患者正确使用隐喻的能力严重不足。基于对谚语的解读,关于精神分裂症患者错误解读是由于个人冲突交织的假设被否定。另一方面,可以证明对谚语的具体性解读代表了对冲突的回避。“替代”和“转移”的概念使我们能够衡量病理性具体性和“去冲突化”。精神分裂症患者与非精神病患者之间的差异被发现具有高度显著性。在一项补充研究中可以表明,慢性精神分裂症患者将谚语意象转移到人际相关情境的能力与首次发作的精神分裂症患者相比,并无显著差异。在讨论我们的实证研究结果时,我们试图表明思维和言语的具体性简化也是妄想的一个范例。精神分裂症妄想的“顽固性”被认为是基于言语符号和隐喻的实体化。在试图展示具体性的“生活形式”(维特根斯坦)与精神分裂症患者紊乱的意向性之间的联系之后,给出了心理治疗意义的提示。