Psychological Science ›› 2017, Vol. 40 ›› Issue (4): 1011-1016.
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Xian-Jun Xu1,CHEN Wei
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徐献军1,陈巍2
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Abstract: The field of schizophrenia research is dominated by the theory which focuses on the delusion. This theory advocates that relative special symptoms of schizophrenia can be observed most easily in the delusion perception. Then nondelusional schizophrenia which doesn’t have obvious symptoms is neglected. In Blankenburg’s view, though schizophrenic patients exhibit their world in the delusion more clearly and intuitively than in other psychopathological appearance, but it doesn’t mean that schizophrenia only manifests itself in the delusion. He tried to search the essence of schizophrenia in the nondelusional and symptom-poor forms, especially hebephrenic and simple type. He belongs to the tradition of phenomenological psychopathology founded by Karl Jaspers, so his methodology is phenomenological. In 1912, Jaspers proposed that phenomenology should be the preparative discipline of psychopathology because it could help psychiatrists understand what the patients really experienced. The phenomenological psychopathology focuses on the study of subjective experiences and gives high value to the self-descriptions of patients. So it differentiates greatly from the biological psychopathology which focuses on the study of neurological mechanisms. In the last decade, phenomenological psychiatry has underwent a rather prominent recovery because much theoretical and empirical work becomes to be interested in the systematic study of subjective experience of mental disorder. Despite progress in identifying the neural substrates of schizophrenia, phenomenology deserves to be at the center of any effort to investigate schizophrenia, because it makes accessible the symptoms reported by the patient and it can help researchers find out etiology of schizophrenia. Based on the phenomenological analysis of his patients’ self-descriptions, Blankenburg put forward that the loss of natural self-evidence is the core of schizophrenic change. According to the Edmund Husserl’s transcendental phenomenology, the loss of natural self-evidence can be traced back to the four changes: (1) the change of the relation to the world; (2) the change of temporal construction; (3) the change of self-construction; (4) the change of the relation to others. First, schizophrenic patients can’t deal with their world like the healthy because they have lost the transcendental planning or passive genesis and they have to be charged with the work which should have been done in the unconsciousness or automatically. So they exhaust their strength shortly and express the schizophrenic asthenia. Second, schizophrenic patients’ time construction happens to be spilt and the integrity of their past, now and future has collapsed. They can’t utilize their past, so they can’t enter their future. Third, schizophrenic patients are short of self-supporting and can’t accomplish self-construction. More specifically, their self-weakness occurs on the low-level of self, i.e. the level of transcendental performance. In other words, the defected is their transcendental self that is the original and primary one. Four, schizophrenic patients’ relation to others or their intersubjective construction has changed greatly and it is the source of the loss of natural self-evidence. DSM-5 calls it asociality. Patients can’t shift themselves into others’ place automatically due to the loss of common sense, so they have to do it consciously and hardly. The psychiatrists in the English countries mainly used to rely on the positive symptoms in the diagnose of schizophrenia, but in the recent decades they become to pay more attention to the negative symptoms. And DSM-5 has ranked the negative symptoms as one of the core characters of schizophrenia. In this case Blankenburg’s work has special importance for the study of schizophrenia because it provides the best explanation of the subject dimension of the negative symptoms. The researchers who want to understand the negative symptoms, mustn’t ignore his work. As one of the greatest representative of the phenomenological psychopathology, he has influenced on the temporary study of schizophrenia and cognitive sciences deeply. Recently, Leonhard Schilbach and others have suggested that the “mirror neuron system” (MNS) and the “mentalizing network” (MENT) are key substrates of the loss of natural self-evidence.
Key words: schizophrenia, phenomenological psychopathology, self-evidence, negative symptom, social cognition
摘要: 传统的精神分裂研究,关注的主要是精神分裂的妄想症候群。因为相对特殊的症状,在妄想形式中可以得到最轻易的把握。Blankenburg则认为:精神分裂的本质结构改变是先于妄想的。因此,他致力于在精神分裂的症状贫乏型(主要是青春型和单纯型)中,寻找精神分裂的本质变化。他发现:精神分裂异常中的核心缺损是自然自明性的失落。根据胡塞尔的超验现象学,自然自明性失落有四个原因:与世界关系的改变、时间建构的改变、自我建构的改变、与他人关系的改变。Blankenburg的精神分裂理论,可被视为二十世纪有关精神分裂的最重要工作之一。
关键词: 精神分裂 现象学精神病理学 自然自明性 负面症状 社会认知
CLC Number:
B84-09
Xian-Jun Xu CHEN Wei. The Loss of Natural Self-Evidence ——On the Blankenburg’s Schizophrenia Theory[J]. Psychological Science, 2017, 40(4): 1011-1016.
徐献军 陈巍. 自然自明性的失落——Blankenburg精神分裂理论述评[J]. 心理科学, 2017, 40(4): 1011-1016.
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https://jps.ecnu.edu.cn/EN/Y2017/V40/I4/1011