Schizophrenia, the Very Idea — with Reflections on Hyperreflexivity

The purpose of this talk (based on a recent paper by Sass & Feyaerts, 2024) was to consider schizophrenia—the very idea—from the perspective of phenomenological psychopathology, with special attention to 1, the problematic nature of the diagnostic concept, 2, the prospect and challenges inherent in focusing on subjective experience, and 3, the advantages of a revised version of the well-known basic-self or ipseity-disturbance model (IDMrevised). Particular attention is paid to the key concept of hyperreflexivity—a form of exaggerated self-awareness that tends to undermine normal world-directedness and the stability of self-experience. Professor Sass considered forms of exaggerated “self-presence” that are sometimes neglected, yet imbue classically schizophrenic experiences involving quasi-solipsism or ontological paranoia. The revised model aims to respect the heterogeneous, indeed paradoxical aspects of schizophrenia while also capturing the “specific mental totality” of schizophrenia or schizophrenia spectrum, and also the “kernel of truth not present with other [diagnostic] groupings” (Karl Jaspers). The paper is highly encompassing and, in this sense, ambitious. It is, however, also modest in its acknowledgment (though also its justification) of various forms of ambiguity or obscurity that attend the model—some of these pertaining to the difficult nature of the study of subjectivity, others to the notion of hyperreflexivity in particular.