The Philosophy of Schizophrenia Term Paper

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Trinity College

In his book, The Paradoxes of Delusion, Louis Sass attempts to rebut two of most

prevalent beliefs of the schizophrenic person. He argues that by viewing the

schizophrenic delusions in light of solipsism, a philosophy of existence, the

schizophrenic may seem far more understandable. Through his comparison of the

schizophrenic and solipsist realities, Sass explains that not only is schizophrenia

understandable, but that there exists within the structure of schizophrenic delusion a

seemingly self-contradictory state which in actuality approximates a sort of logic more

than anything else. Thus, according to Sass, schizophrenia should not be deemed a state

of unreason, but rather a reason which results from a dual conceptualization of the


Sass first introduces the traditional understanding of madness and delusion. The

most fundamental basis under which a person is diagnosed as insane is when he displays

a poor of false understanding of his environment, called "poor reality testing."

"...disturbance in or failure of "reality-testing" is considered to be the defining criterion

for diagnosing a so called psychotic condition."(p.1) The inability to correctly perceive

reality is considered to be the basis for delusion, the basic characteristic of madness. But,

as Sass explains, patients with schizophrenia, "the most severe and paradigmatic kind of

insanity," often do not display actual poor reality-testing.

While schizophrenic patients tend to accord great importance to their delusions,

they do not handle said delusions in the same way that they handle what they understand

to be objective reality. "...many schizophrenics who seem to be profoundly preoccupied

with their delusions...treat these same beliefs with what seems a certain distance and

irony."(p.20-21) They seem to retain two understandings of reality, so called "double

bookkeeping," which allows them to exist "in two parallel but separate worlds:

consensual reality and the realm of their hallucinations..."(p.21) This concept helps to

explain why many schizophrenic patients do not act on their delusions in a manner which

is appropriate for the given delusional situation. "A patient who claims that the doctors

and nurses are trying to torture and poison her may nevertheless happily consume the

food they give her."(p.21) They believe that their delusions are real, but only in the

context of a world known only to them. "Schreber insists...that such beliefs-he calls

them "my so-called delusions"-refers to a separate realm, one that does not motivate him

to act and wherein the usual criteria of worldly proof does not apply."(p.31)

While common understandings of poor reality testing include a patient's belief in

things which are objectively false or non-existent, Sass argues that many schizophrenics

also disbelieve those things which can be deemed objectively true or real. "...often

schizophrenic delusions involve not belief in the unreal but disbelief in something that

most people take to be true. Schizophrenic patients may..speak disbelievingly of "my

so-called children and this so-called hospital..."(p.24) Along with these "delusions of

disbelief," schizophrenic patients may perceive other human beings as machines or

phantoms which just seem to be real people.

Sass also explains how schizophrenic patients may believe that many of their

experiences are products of their own mind and consciousness, as if they have created the

reality which surrounds them by their own thought. "Schizophrenics may believe that

they have invented everything they encounter-that...they themselves have just invented

the story they have just read"(p.22) Schreber believed that the insects he saw were

created at the moment he looked at them, and disappeared as soon as he looked away.

These examples, along with the schizophrenic suspicion concerning the reality of other

human beings, are central to Sass' likening of schizophrenia to the philosophical notion

of solipsism.

A solipsist believes that his reality is the only true reality, or as Wittgenstein puts

it, "The world is my idea."(p.34) Most basically, solipsism refers to the belief that

everything one perceives is a product of his own mind. Like the schizophrenic, the

solipsist views other people as phantoms of a sort. "For the solipsist, other people, other

seeming centers of consciousness, are but dream personages, figments of the solipsist's

own conscious activity and awareness."(p.34) Because the most basic tenets of solipsism

are lived out in the schizophrenic delusions, Sass believes that by considering the

symptoms of schizophrenia in light of the solipsist model of reality, we can gain an

understanding of much of the schizophrenic condition.

Sass explains that Wittgenstein saw a strong connection between solipsism and

intense concentration or "staring." "The phenomenon of staring is closely bound up with

the whole puzzle of solipsism."(p.35) Wittgenstein also noted the importance of

inactivity to the solipsist experience. Sass explains that by interacting with and moving

about the world, a person has no choice but to accept the physical and objective quality

of everything around him. This recognition "precludes a sense of...subjectivization"

(p.35) thus hindering the solipsist understanding that everything he sees is, in effect, a

product of his own mind.

By interacting with the is obliged to recognize

the world's a passive state, the world may

look rather different. The more one stares at things, the

more they may seem to have a coefficient of subjectivity;

the more they may come to seem "things seen." When

staring fixedly ahead, the field of consciousness as such

can come into prominence; then, it is as if the lens of

awareness were clouding over and the world beyond were

taking on the aphanous quality of a dream. At this point,

the person can be said to experience experience rather than

the world...(pp.35-36)

This is to say that the longer we stare at something, the more we think of a certain object

in the sense of a visual, rather than physical object. Viewed as the concept of an object

rather than an object in and of itself, the thing takes on a highly subjective quality. "In

this situation, any object of awareness tends to feel that it depends on me in some special

way, belonging to my consciousness as a private and somehow inner possession."(p.36)

Sass points out that many of Schreber's schizophrenic experiences were

accompanied by just such circumstances of intense concentration and almost complete

inactivity. "Apart from daily morning and afternoon walks in the garden, I mainly sat

motionless the whole day on a chair at my table..."(p.37) It appears that certain types of

delusions would not occur if Schreber were moving around. "The experience of

"miracled-up" insects...seems not to have occurred unless Schreber was in a state of

immobility...if he sat down and waited he could actually provoke this wasp miracle."


Schreber's experience of the "wasp-miracle" is perhaps the very best example of

the proximity of the schizophrenic and solipsist realms. He believed that his gaze

provoked the spontaneous generation of the insects, an understanding which gave

Schreber the "sense of being the conscious center before whom and for whom events

appear."(p.38) Sass also points out passages of Schreber's Memoirs which indicate his

awareness that other minds cannot exist, a fundamental notion of solipsism. "The

solipsist, who is so struck with the undeniable actuality and centrality of his own

experience, obviously cannot have this same awareness of the experience of others. In

fact, the more he pays attention to his own experience, the more unlikely it seems that

other people can have anything like this-and the more others come to seem...not really

conscious beings at all."(p.39)

An understanding of solipsism helps us to see why the schizophrenic patients fail

to respond to their delusions or react in what seems an inappropriate manner. As Sass

explains, both schizophrenics and solipsists see reality as a mental reality of concepts or

ideas. Thus is would be largely futile to attempt to act out in any physical way because

tangible maneuvers could have no affect in a world where nothing is of substance. "

a solipsistic universe, to act might feel either unnecessary or impossible: unnecessary

because external conditions are at the mercy of thought...impossible because real action,

action in a world able to resist my efforts, cannot occur in a purely mental universe."

(p.42) In light of this "merely mental or representation" understanding of the world, it

seems clear that a schizophrenic person would naturally speak in metaphor, something

which Sass believes is often unknown or ignored. "A failure to realize that a patient may

be describing such a mode of experience can...lead to an overly literal interpretation by

the therapist, and thus the mistaken impression that the patient's reality testing has

broken down."(p.44) Additionally, schizophrenic patients often perceive their own

physical bodies as representational or conceptual. So when they have delusions of their

bodies and other people's bodies undergoing radical physical changes, they are not

bothered by it because it seems affectless and inconsequential, as if one were cutting up

paper dolls.

Sass explains that consideration of the solipsist reality can illustrate a potential

reason for the schizophrenic anxiety, described by a doctor of Schreber's as a "tense" and

"irritable" state "caused by inner uneasiness."(p.37) With the belief that the world is a

product of one's own mind comes, to a schizophrenic patient, an immense feeling of

responsibility. They lack the luxury of having the ability to "stop playing the game," if

you will, and leave their beliefs behind. While the notion of single-handedly controlling

existence is accompanied by a sense of awesome power, it also proceeds a fear of

causing the demise of the universe. "One catatonic patient explained why she would

hold herself immobile for hours in an uncomfortable was, she said, for the

purpose of 'stopping the world march to catastrophe': 'If I succeed in remaining in a

perfect state of suspension, I will suspend the movement of the earth and stop the march

of the world to destruction.'"(p.50)

Wittgenstein believes, and rightfully so, that solipsism is wrought with

contradiction. Sass also admits that schizophrenic patients are often plagued by their

own contradictions, most notably simultaneous feelings of omnipotence and impotence,

and the desire to make others understand their experience while believing that they are

the only people capable of experience. Many of these contradictory notions do not work

within the context of the solipsist world view, and thus appear at first to work against

Sass' crucial comparison between schizophrenia and solipsism. However, Sass proposes

that the contradictory nature of the schizophrenic experience does not undermine its

close relation to solipsism, but rather demonstrates the proximity of schizophrenia to the

inherently contradictory nature of solipsism itself.

Schizophrenics typically oscillate persistently between a feeling of being a virtual

master of the universe and a belief that their very being is in some way inconsequential.

"Schreber senses at times that his boundaries extend to the ends of the universe: "It

appeared that nerves-probably taken from my body-were strung over the whole heavenly

vault." But he also feels that he is tiny, and almost nonexistent being lost in the vastness

of space."(p.65) While the latter may seem to contradict Sass' link between the

schizophrenic delusional world and the solipsist understanding of reality, Sass explains

that if we simply follow Wittgenstein's argument against the solipsistic viewpoint, we

see that even in self contradiction, the schizophrenic reality may maintain it's close

connection with solipsism. A solipsist begins by believing in his central, controlling role

of the universe. Staring and intense concentration give a person the feeling that "only me

experience of the present moment is real."(p.67) But, as Wittgenstein explains, if a

person follows the solipsist principles carefully, he will soon realize that he is does not

see himself in his existence, even though his experience is all that really is. "If he closely

scrutinizes his experiences-which...are all that exists-he must admit that he does not find

himself there."

He goes further to say that if a solipsist did see himself in his world, it could only

be as an object of that world, which is, in affect, a product of thoughts and ideas. He

cannot, from this experience, affirm his omnipotence. "...even if one did see oneself

within one's experience, that self, being within the phenomenal field, could exist only as

an object, not in the role of the all powerful constituting subjectivity for which the

solipsist yearns..."(p.68) Furthermore, since the solipsist believe the only reality is that

which is perceived, and since he cannot perceive himself as anything but an object of his

own consciousness, it is necessary for the solipsist to believe there is another conscious

being which perceives him as an object, thus confirming his object reality. But this

concession also undermines the primary tenet of his reality being the only reality.

With all of this in mind, it seems clear that the schizophrenic patients could

understandably feel both all and nothing at the same time. In Schreber's case, Sass

points out, his "sense of being the solipsistic center occurred at those moments when he

was also experiencing the contradictory presence of another mind."(p.73) The "one"

whom Schreber speaks of so frequently is generally a believer in the idea that Schreber

creates the world around him. This also gives insight into the typical schizophrenic "loss

of self," that is, the felling that one's thoughts are belong to some other consciousness or

no one at all. This could also be related to the feeling which schizophrenics have of

some foreign power controlling the direction of their gaze.

By demonstrating that schizophrenia mirrors a philosophic notion like solipsism,

Sass successfully illustrates that it is not entirely accurate to believe in schizophrenia as a

state of unreason. While one might correctly state that solipsism is in some way illogical

and unreasonable in and of itself, it would be still be reasonable to conclude that there is

some inherent logic or reason in the discovery of this inherent self-contradiction. If

something is self-contradicting by nature, it is logical to conclude that this is illogical,

and thus we should not view schizophrenia as unreason because there is a sort of logic to

its illogical nature. Within the context of solipsism, it makes perfect, logical sense that a

person should feel almighty and powerless at the same time. It would seem then, that

schizophrenia is, in a sense, the illogic of solipsism taken to it's logical conclusion.

Part of the reason Sass' conclusion makes so much sense is the simple fact that

much of what the schizophrenics do does not look or sound like unreason, but rather like

a preoccupation or obsession with reason itself. They constantly examine and scrutinize

every aspect of themselves and their existence. They do mental checks and rechecks to

make sure they are actually participating in the activity which they believe they are.

They overanalyze every aspect of normal human processes and nature, and search for the

reason and explanation behind every twitch and jitter, every sound their body makes.

Their mode of though is not unreason but over-reason, in which they often concentrate on

one object for so long that it begins to take on a surreal quality within a person's own

mind. As Sass points out, "it is significant that schizophrenic patients often do report

that performing some action or interaction with others makes their odd perceptual

experiences disappear-that when they comb their hair or shovel snow...the world turns

normal again, at least for a time."(p.113) This suggests that when a schizophrenic person

removes himself from the passive world, he has the ability to stop the delusions-the

delusions are at least partially a result of over analysis of the consensual world. Schreber

tries to escape this world of "compulsive thinking," but cannot.

We must also take into consideration another important aspect of schizophrenia

which Sass points out, namely, "uncanny particularity." Schizophrenics often view the

world with a perpetual feeling that everything is happening for a particular reason, that

every action and occurrence points to something else. Unfortunately, they rarely know

what such things point to, or why certain occurrences are important: they simply know

that they are. "A patient may see a dog lifting its left paw...or notices a red pickup truck

parked on a bridge under which he is about to pass. At the same time, he feels absolutely

sure that this is not an accidental if there were something just too

precise..."(p.100) This conception of reality, in which a person feels that everything he

sees is somewhat symbolic or indicative of something else, helps us to understand why

schizophrenics have such problems facing the objective world in a non-metaphorical

sense. It also sheds light on the desire of the schizophrenic to constantly analyze

everything for meaning-while he has a fundamental belief that every event has meaning

or a purpose, he does not know what that purpose or meaning is, and thus searches for it

just as any sane person would do in such a situation.

Though their explanations for things do not always jive with objective reality, yet

this certainly does not mean that their whole thought process is illogical. Their mode of

reason works perfectly within their own delusional world-we as sane people seem to lack

the desire to enter this world, though clearly accessible by basic manipulation of a

philosophic precept. More often than not a schizophrenic knows what he says doesn't

mean anything to you-this shows not only an understanding of this reality but a

fundamental understanding of their own.

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