Stephensen Helene, Urfer-Parnas Annick, Parnas Josef
Center for Subjectivity Research, University of Copenhagen, Copenhagen, Denmark,
Mental Health Centre Glostrup, University Hospital of Copenhagen, Broendby, Denmark,
Psychopathology. 2024;57(6):459-469. doi: 10.1159/000538707. Epub 2024 Jul 16.
In this paper, we wish to elucidate alterations of basic existential and intersubjective configurations in schizophrenia spectrum disorders (SSD) through the phenomenon of Anderssein ("feeling different"). Anderssein is an important yet neglected notion from German psychiatry, referring to a specific sense of feeling profoundly different from others occurring in SSD. Although phenomenological-psychopathological research mentions it as an aspect of the core disturbance of SSD (namely, "self-disorders"), the phenomenon has not yet been explored in empirical or theoretical detail.
We present material from a phenomenological-empirical study on the mode and onset of psychosis based on qualitative interviews with 25 patients with SSD.
Most of the participants in our study report having felt fundamentally and often ineffably different since childhood and articulate it as a sense of existing "outside" of the shared reality. Intersubjective reality appears progressively unreal or inauthentic, and simultaneously, the patient's intimate, subjective sphere is permeated by an alien otherness. Importantly, this outside position should be understood carefully as it is often accompanied by the sense of being invaded by social rules, other people's thoughts, or emotions. Incipient psychosis is described as a gradual extension of precedent alterations of the structures of (inter)subjectivity.
We conceptualize the ontological feature of Anderssein as an altered "being in-between" - that is, some sort of halting of the dynamic movement between particularity and intersubjectivity. Finally, we discuss the critical implications of these results for research into the "onset" of schizophrenia.
在本文中，我们希望通过“异己感”（Anderssein）这一现象来阐明精神分裂症谱系障碍（SSD）中基本存在性和主体间性结构的改变。“异己感”是德国精神病学中一个重要但被忽视的概念，指的是在SSD中出现的一种与他人深刻不同的特殊感觉。尽管现象学-精神病理学研究将其作为SSD核心障碍的一个方面（即“自我障碍”）提及，但这一现象尚未在实证或理论层面进行详细探讨。
我们展示了一项基于对25名SSD患者进行定性访谈的关于精神病发作模式和起始的现象学-实证研究的材料。
我们研究中的大多数参与者报告称，自童年起就感觉自己从根本上且常常难以言表地与众不同，并将其表述为一种存在于共享现实“之外”的感觉。主体间现实逐渐显得不真实或虚假，同时，患者亲密的主观领域被一种陌生的异质性所渗透。重要的是，这种外在位置应谨慎理解，因为它常常伴随着被社会规则、他人的思想或情感侵入的感觉。初期精神病被描述为（主体间）性结构先前改变的逐渐扩展。
我们将“异己感”的本体论特征概念化为一种改变了的“处于两者之间的存在”——也就是说，某种特殊性与主体间性之间动态运动的停滞。最后，我们讨论了这些结果对精神分裂症“发病”研究的关键意义。
