SCHIZOPHRENIA: A DISORDER OF

INTERSUBJECTIVITY
A phenomenological analysis

Inauguraldissertation zur Erlangung der Doktorwürde der

Philosophischen Fakultät der Universität Heidelberg

vorgelegt von Zeno Van Duppen

Erstgutachter: Prof. Dr. Dr. Thomas Fuchs

Zweitgutachter: Jun.-Prof. Dr. Thiemo Breyer
27. Juli 2016
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 TABLE OF CONTENT

ACKNOWLEDGEMENTS ................................................................................................................... 5
PREFACE............................................................................................................................................... 6
CHAPTER 1. THE DISORDER OF THE SELF AND ITS PROBLEMS ....................................... 8
1.1 The self ..................................................................................................................................................... 8
1.1.1 Hume, Kant, Husserl ....................................................................................................................................8
1.1.2 Minimal self.................................................................................................................................................. 13
1.1.3 Extended self ............................................................................................................................................... 19
1.2 Self-disorders ..................................................................................................................................... 21
1.2.1 Psychiatric disorders and disturbances of the self...................................................................... 21
1.2.2 Schizophrenia as a self-disorder ......................................................................................................... 26
1.2.3 Which self is affected? ............................................................................................................................. 33
1.3 Self and intersubjectivity: developmental psychology and psychopathology ............ 35
1.3.1 Developmental psychology ................................................................................................................... 35
1.3.2 Psychopathology of intersubjectivity................................................................................................ 41
1.4 Purpose and method ........................................................................................................................ 44
1.4.1 Research Questions .................................................................................................................................. 44
1.4.2 Method ........................................................................................................................................................... 45
CHAPTER 2: THE PHENOMENOLOGY OF INTERSUBJECTIVITY ...................................... 48
Introduction ............................................................................................................................................................ 48
2.1 Encounters – The other, and others as constituted .............................................................. 52
2.1.1 Empathy – on experiencing others .................................................................................................... 52
2.1.2 The other as other ..................................................................................................................................... 59
2.1.3 Solipsism ....................................................................................................................................................... 64
2.1.4 Sociality and personhood....................................................................................................................... 68
2.2 The shared world - I, the other, and the others as co-constituting ................................. 71
2.2.1 Intersubjective reality in phenomenology ...................................................................................... 71
2.2.2 Intersubjective perception .................................................................................................................... 72
2.2.3 The objectivity of the world .................................................................................................................. 77
2.2.4 Normality ...................................................................................................................................................... 80
2.2.5 Subjectivity in an intersubjective world .......................................................................................... 81
2.2.6 The problems of transcendental intersubjectivity ...................................................................... 83
2.3 Summary concerning Husserl’s successors on intersubjectivity .................................... 85
Conclusions ................................................................................................................................................ 88
Section 2.1 ............................................................................................................................................................... 88
Section 2.2 ............................................................................................................................................................... 90
General conclusion of Chapter 2 .................................................................................................................... 93
CHAPTER 3: THE PSYCHOPATHOLOGY OF INTERSUBJECTIVITY IN SCHIZOPHRENIA
.............................................................................................................................................................. 94
3.1 Conceptual analysis of schizophrenia as an intersubjectivity disorder ....................... 95
3.1.1 Kraepelin ....................................................................................................................................................... 95
3.1.2 Bleuler ............................................................................................................................................................ 98
3.1.3 Jaspers ......................................................................................................................................................... 104
3.1.4 Minkowski ................................................................................................................................................. 110
3.1.5 Kimura ........................................................................................................................................................ 118
3.1.6 Blankenburg ............................................................................................................................................. 125
3.1.7 The contemporary neuropsychological approach to schizophrenia ................................ 133
3.2 Manifestations of disturbed intersubjectivity in schizophrenia ...................................143

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 3.2.1 Encounters with others ....................................................................................................................... 143
3.2.1.1 Encounters and intersubjectivity of the shared world ...................................................................... 144
3.2.1.2 Encounters and intersubjectivity in the delusional world .............................................................. 153
3.2.2 Towards the world – with others .................................................................................................... 157
3.2.2.1 Double book-keeping and the primary delusional experience ...................................................... 158
3.2.2.2 Six factors of hypo- and hyperreality ........................................................................................................ 160
Conclusions .............................................................................................................................................. 173
CHAPTER 4. PSYCHOPATHOLOGY AND PHILOSOPHY OF INTERSUBJECTIVITY ....178
4.1 From self-disorder to intersubjectivity-disorder ............................................................... 178
The limits of the current phenomenological approach ..................................................................... 179
4.2 Open subjectivity ............................................................................................................................ 183
4.2.1 What is open subjectivity? .................................................................................................................. 184
4.2.2 Five dimensions of open subjectivity ............................................................................................. 188
Temporality: implicit and explicit time ................................................................................................................... 188
Spatiality: in-between the spheres of self and other ......................................................................................... 191
Affectivity.............................................................................................................................................................................. 192
Reality .................................................................................................................................................................................... 194
The sense of self and the sense of other.................................................................................................................. 196
4.2.3 Alterity, transitivism, and diminished self-affection ............................................................... 198
Conclusions .............................................................................................................................................. 200
CHAPTER 5. CONCLUSION .........................................................................................................202
5.1 Summary of the chapters ............................................................................................................. 202
5.2 Future research ............................................................................................................................... 207
REFERENCES ..................................................................................................................................210

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 ACKNOWLEDGEMENTS
My gratitude goes to the Deutsche Akademische Austausch Dienst (DAAD) for awarding me
with a scholarship, which made it possible for me to move to Heidelberg and start my work in
phenomenological philosophy and psychopathology.

I would like to thank my supervisor, Thomas Fuchs, for the opportunities he gave me to study
and develop my ideas in a place where the history and future of phenomenological
psychopathology meet. I am grateful for all the discussions in the colloquiums and seminars, for
his profound interest, critiques and support, and for the collaborations in both research and
teaching. His work in philosophy and psychopathology has had a great influence on my own
ideas. The Section for Phenomenological Psychopathology and Psychotherapy is an exceptional
research group. I cannot think of any other place where philosophers, psychiatrists, and
psychologists can collaborate in such a way and I consider my time in Heidelberg as an
enormous enrichment.

Secondly, I want to thank Thiemo Breyer, for the advice and critique on my work and for his
encouragements and guidance in the past years. Although we only briefly worked together in
Heidelberg, he continued to challenge and strengthen my arguments.

I am also grateful to a lot of people who spent time at the Section, and with whom I had the
pleasure to work. They have all directly or indirectly contributed to this dissertation, and I thank
them for all the meetings, discussions, and evenings spent together: Joshua Connor, Christoph
Durt, Mike Finn, Rixta Fambach, Sonja Frohoff, Laura Galbusera, Lukas Iwer, Stefan
Kristensen, Stefano Micali, Tim Schnitzler, Shogo Tanaka, Christian Tewes, and Jaoa Machado
Vaz.
More specifically, I would like to thank Dusan Hirjak and Katharina Kubera for their guidance
during the months I spent as a visiting doctor at the University Psychiatric Hospital of
Heidelberg. Both our clinical work and discussions on psychiatry have greatly inspired me.

Among my colleagues, I want to thank in particular Till Grohmann, Anastasia Kozyreva,

Michela Summa, and Samuel Thoma for their ideas and corrections, which have vastly
influenced the final outcome of this dissertation. I had the pleasure to spend most time with
them, either because of collaborations, joint teaching, or shared interest and I am grateful for
their continuous patience and efforts to school me in phenomenology, as well as for their
friendship. I am also grateful to Tessa Marzotto for carefully proofreading the entire text.

I cannot express how grateful I am to my family, for supporting me and reminding me of what
matters most. From my initial plan to combine the study of medicine and philosophy, to the last
days of this doctoral period, they have been there for me.

Lastly, I thank my fiancée, Evelien, for her love and care. It may seem little, but it is all.

5
 PREFACE
This dissertation combines two scientific disciplines and research fields, namely
philosophy and psychopathology. Within such a wide field of investigation, two precise
perspectives are to be adopted in this inquiry: stemming from the first field, the
phenomenological perspective on subjectivity and intersubjectivity; stemming from the second,
the psychopathological perspective on schizophrenia. The combination of philosophy and
psychopathology has often proven fruitful. Moreover, the main motivation for such a combined
approach is justified by the strong belief that, when critically used, phenomenology offers a
viable method of studying the first-personal perspective of experience, including the experiences
of people with mental disorders. Philosophical analysis can thereby be used as a means to
evaluate the meaning and adequacy of psychopathological concepts and ideas. As a result,
phenomenological psychopathology may help understand what is often claimed to be
incomprehensible. Particularly for the understanding of schizophrenia, this is taken to be a
valuable contribution.
For more than twenty years now, the phenomenological approach to schizophrenia has
developed a strong and influential hypothesis on the basic alterations of this disorder.
Schizophrenia, it is claimed, is a disorder of subjectivity, and more specifically, a disorder of the
minimal self. Simultaneously, and often in conjunction, philosophical research on the self has
vastly proliferated. The vivid interaction between these two fields makes the phenomenology of
schizophrenia a good example of effective interdisciplinary work. Within the philosophical
debate on subjectivity, intersubjectivity, or the relation between self and other, is currently a key
topic. However, this has not significantly influenced the psychopathology of schizophrenia yet.
The initial and fundamental claim of this dissertation is indeed that a renewed evaluation and
inclusion of intersubjectivity, next to subjectivity, is to increase the validity of the
phenomenological approach to schizophrenia. This would allow the previous hypothesis on
schizophrenia as minimal self disorder to be challenged, criticized, or complemented, which
would accordingly increase the significance and its clinical value. What I will attempt to do in
this dissertation is then to thoroughly evaluate the role of intersubjectivity in schizophrenia. It
will hence become clear what this role and its significance are. Consequently, I will finally argue
that the basic alterations of schizophrenia concern both subjectivity and intersubjectivity.
My argument is developed in four chapters. In the first, I introduce the topic of the self,
including the distinction between the minimal and the extended self. This chapter equally

6
introduces schizophrenia as a psychiatric concept, and three different clinical approaches are
discussed, among which the phenomenological approach in most detail. After the topics of the
self and schizophrenia, I introduce intersubjectivity, notably from a developmental-psychological
perspective. By way of status quaestionis, I recapitulate the current research on intersubjectivity
and schizophrenia. It will become clear that this research is relatively scarce. I then conclude the
chapter with a full formulation of the two research questions informing this dissertation, namely
Is schizophrenia an intersubjectivity-disorder? and Which self-concept is suited to define
schizophrenia as a self and intersubjectivity disorder?
The second chapter examines the phenomenology of intersubjectivity. The exact
delineation of what is meant here by intersubjectivity will allow the reader to acknowledge its
extent and variety. This chapter is aimed to provide the necessary philosophical tools to analyse
schizophrenia in the light of intersubjectivity. In the third chapter I turn to psychopathology. In
the first section, I analyse the work of seven major psychopathologists on schizophrenia. The
goal of this section is to look for elements of intersubjectivity in their accounts of schizophrenia.
Many of these psychopathologists have been influential for the development of the current self-
disorder hypothesis, and the investigation intends to show how some crucial intersubjective
elements in their work have been neglected. In the second section of this chapter, I focus on the
symptoms, signs, and phenomena of schizophrenia that relate to intersubjectivity. This chapter
finally offers all the material needed to positively answer the first research question.
In the fourth chapter, I bring together psychopathology and philosophy, and I attempt to
answer the two research questions. Since Chapter 3 allows me to affirmatively answer the first
question, I examine whether the current self-disorder hypothesis is adequate to integrate
intersubjectivity disturbances. It will appear that it is not, and the first section of this chapter
consequently deals with the question why intersubjectivity and its disturbances have been
neglected until now. In the second section it will become clear that no different self-concept is
required, but that schizophrenia primarily concerns a particular capacity or orientation of
subjectivity. I introduce the concept of open subjectivity and thereby answer the second research
question. By describing schizophrenia as a disturbance of open subjectivity, I am finally able to
integrate both self-disturbances and intersubjectivity-disturbances into a coherent and unified
theory.
To conclude this dissertation, I summarize and recapitulate its major issues, questions, and
results in Chapter 5. Both clinical implications and possible future research are also discussed
here.

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 CHAPTER 1. THE DISORDER OF THE SELF AND ITS
PROBLEMS
This chapter is a broad introduction to the topics and questions of this dissertation. The
first section of this chapter is meant to provide a brief introduction to the topic of the self. After
summarizing the positions of Hume, Kant, and Husserl, I turn to the contemporary distinction
between the minimal and the extended self. This distinction is highly relevant, as schizophrenia
is claimed to be a disorder of the minimal self. In the second section of this chapter, I therefore
introduce the self within psychopathology. This section should allow to understand what
schizophrenia is, how it is diagnosed, and which theories and approaches currently prevail. The
phenomenological approach to schizophrenia is of great interest to the aim of this dissertation, as
it is precisely this approach that will be challenged, criticized, and possibly complemented. Since
intersubjectivity is the main focus of this text, I introduce it from both a developmental-
psychological, as well as from the psychopathological perspective. It will become clear that there
is a relative scarcity of research on schizophrenia and intersubjectivity. This, finally, leads me to
formulate two research questions.

1.1 The self

1.1.1 Hume, Kant, Husserl

This inquiry into the intersubjective dimensions of schizophrenia starts from the
preliminary assumption that schizophrenia is a self-disorder. In order to understand the idea
behind this definition, some light should be shed on both its constituent elements: what is the self
and how can the self become disordered?
Throughout the history of philosophy the question of the self has evoked myriads of
theories and a rich debate has emerged. Is the self the soul? Is it our Ego? Do I have a self, or am
I a self? How does the self relate to the person and its identity? Is identity a matter of continuity
over time? And of course: how does the self relate to others?
Even though these are not new ideas, they still draw the attention of contemporary thinkers
and scientists. A great variety of answers has been given to the questions of the self. Some have
even denied its existence. Others have argued in favour of the existence of different selves,
depending on the role they play in mental life and in the interaction with the world. In what
follows, I will briefly illustrate three of the most significant directions undertaken in the attempt

8
to answer the question of what the self is. First, I question the existence of the self with David
Hume and what has been traditionally referred to as the “bundle theory of the self”. Secondly, I
follow Immanuel Kant’s arguments supporting the ‘synthetic unity of apperception’ and discuss
the role of the ‘I think’. Lastly, I turn to Edmund Husserl’s phenomenological view, which was
the main inspiration for Zahavi’s account on the minimal self.
Hume questioned the assumption that the self exists. His Treatise of Human Nature (2003)
develops an implicit argument against the idea of a strong, independent self, as advocated by
René Descartes’ philosophy. As is well known, Descartes attempted to ground scientific
knowledge on a fundament of irrefutable certainty. His method of radical doubt led him to
conclude that there is at least one certainty, namely that the thinking subject exists (1902). In
reaction, Hume writes in section VI: “There are some philosophers, who imagine we are every
moment intimately conscious of what we call our SELF; that we feel its existence and its
continuance in existence; and are certain, beyond the evidence of demonstration, both of its
perfect identity and simplicity” (Hume 2003, 179). According to Hume, the certainty of these
philosophers would weaken if one challenged them to search for any further proof of the self.
The certainty of Descartes’ famous adage was altogether unacceptable for the empiricist Hume.
The idea of having a self, Hume argued, must derive from an impression one might have.
Yet, the self cannot be an impression itself. It should be very different from the impressions we
have: it has to be stable and persistent throughout all the ever-changing impressions. “The self is
not any one impression, but that to which our several impressions and ideas are suppos’d to have
a reference” (Hume 2003, 180). He then wondered how all our different impressions and
perceptions could be related to the supposed existing self. “For my part, when I enter most
intimately into what I call myself, I always stumble on some particular perception or other, of
heat or cold, light or shade, love or hatred, pain or pleasure. I never catch myself at any time
without a perception, and never can observe any thing but the perception” (Hume 2003, 180).
The stable and persistent self that other thinkers claim to be certain of is something Hume cannot
find. Thus, rational beings should understand “… that they are nothing but a bundle or collection
of different perceptions, which succeed each other with an inconceivable rapidity, and are in a
perceptual flux and movement (…) nor is there any single power of the soul, which remains
unalterably the same, perhaps for one moment” (Hume 2003, 180).
The false impression we have of a stable and persistent self would then be only the result
of our own attempts to feign and disguise the fact that numerous moments interrupt the
continued existence of perceptions, for example during sleep. Hume therefore claimed that we
attribute identity where there is none, and create a fictitious self (Hume 2003, 182, 185). He thus

9
restricted his description of the self, as quoted above, to a bundle of perceptions. He described
this bundle as a theatre, “where several perceptions successively make their appearance.” There
is no self involved in the impressions and perceptions on this theatre, and one should not be
misled to think that the theatre itself, the place where these appearances appear, is the self (Hume
2003, 181). However, it is difficult to understand how this metaphor solves the problem of the
self: one might well ask who would be the spectator of these impressions and perceptions.
Hume’s bundle theory of the self was unable to account for this subjective side (“whose
perception?”) inherent to every experience. Closely related is the question of how the
perceptions of the bundle are connected and thus what constitutes the bundle itself.
This very question was taken up by Immanuel Kant. In Section II of the Deduction of the
Pure Concepts of Understanding, Kant wrote: “The manifold of presentations can be given in an
intuition that is merely sensible, i.e., nothing but receptivity; and the form of this intuition can lie
a priori in our power of presentation without being anything but the way in which the subject is
affected. But a manifold’s combination (coniunctio) as such can never come to us through the
senses” (Kant 1996, 175). While using very different of a terminology compared to Hume’s,
Kant thus argued that the combination of the perceptions themselves could not be the
consequence of only receptivity through the senses, as the empiricist Hume would need to argue.
For Kant, on the contrary, the combination was the result of a particular form of spontaneity,
namely of the act of understanding (Kant 1996, 176). The act of understanding is what he calls
‘synthesis’. “We cannot present anything as combined in the object without ourselves having
combined it beforehand; and that, among all presentations, combination is the only one that
cannot be given through objects, but – being an act of the subject’s self-activity – can be
performed only by the subject himself” (Kant 1996, 176).
The subject plays an active role for Kant, under the form of the ‘I think’. It must be capable
of accompanying all presentations. “For otherwise something would be presented to me that
could not be thought at all – which is equivalent to saying that the presentation either would be
impossible, or at least would be nothing to me. Presentation that can be given prior to all thought
is called intuition. Hence everything manifold in intuition has a necessary reference to the ‘I
think’ in the same subject in whom this manifold is found. But this presentation is an act of
spontaneity; i.e., it cannot be regarded as belonging to sensibility” (Kant 1996, 177). Kant calls
this act of spontaneity, of the ‘I think’, “pure apperception”. The ‘I think’ is something that is
“one and the same for all consciousness”, capable of accompanying every perception one has. If
the possibility of the ‘I think’ were not available, the presentations or perceptions would not be
mine.

10
 However, it is not so much thanks to the potentially accompanying ‘I think’ itself, that
certain presentations are mine, but thanks to the consciousness of my synthetic activity. “Hence
only because I can combine a manifold of given presentations in one consciousness, is it possible
for me to present the identity itself of the consciousness in these presentations” (Kant 1996, 178).
And furthermore: “Only because I can comprise the manifold of the presentations in one
consciousness, do I call them one and all my presentations. For otherwise I would have a self as
many-colored and varied as I have presentations that I am conscious of. Hence synthetic unity of
the manifold of intuitions, as given a priori, is the basis of the identity itself of apperception,
which precedes a priori all my determinate thought” (Kant 1996, 179). It is through
understanding, and explicitly not through the senses, that I can combine given intuitions into a
unity a priori. This synthesis is a requirement, according to Kant, for the thoroughgoing identity
of self-consciousness, and thus, for a stable self.
The role of the synthesis also becomes crucial with regard to the perception and knowledge
of an object. Kant writes that the different intuitions or sensations of the object’s qualities have
to be combined in such a way that they form the object as I experience it, “in order to become an
object for me” (Kant 1996, 179). Kant’s self is thus to be understood as transcendental, in that it
is a condition for experiences of objects through a synthesis of intuitions. The requirement of an
‘I think’ to possibly accompany all my presentations is the fundamental reason why all my
presentations are mine. Kant’s self is thus some transcendental apperception, standing outside of
the stream of ever changing experiences, and combining these experiences into a coherent unity. 1
The third and last fundamental perspective on what the self is derives from Edmund
Husserl. Throughout his work he discussed a variety of ideas on the self, for which he employed
particular concepts: ‘the ego-pole’, ‘the pure ego’, ‘the cogito’, ‘the empirical ego’, ‘the person’.
Here only some of the intriguing elements of his views on the self, the ones most closely related
to Hume’s and Kant’s positions, are to be illustrated. Husserl’s attempt to integrate a self and a
no-self position, will finally guide this research towards the distinction of a minimal and an
extended self in the contemporary phenomenology of the self.
Arguably, Husserl’s most significant contribution to the philosophical tradition was his
formulation of the phenomenological reduction as epistemological foundation for scientific
research. This reduction, or ‘epoché’ consists of suspending or ‘bracketing’ the existence of the
world and all related knowledge, presuppositions, opinions, and beliefs, with the aim of working
out the essences (‘Eide’) of the phenomena. Early on in his work, it seemed as if the

1
I am particularly indebted to Anastasia Kozyreva for the conceptual relation between Hume and Kant and for
the particular approach I chose in this first subsection of the introduction.

11
phenomenological reduction investigated the experiences of a no-one, as if these experiences
happened in a void (Bernet et al. 1996, 190). Whom these experiences belonged to was more a
question of empirical investigation, referring to a human or a person. Husserl assumed it was not
relevant to the phenomenological investigation. The first phenomenological investigations
therefore did not seek to answer the question whose experiences were being investigated, nor
what the role of this subject would be in the experiencing itself.
The early Husserl held then a non-egological position, as was clear in his Logical
Investigations (2001b).2 Arguably, Husserl followed Hume in the denial of a strong independent
Ego or self. However, as Marbach (1974, 100) has shown, he was later confronted with questions
that made him reconsider his views. One of these questions was how one could possibly
distinguish their experiences from the experiences of another person if there was no self in the
first place. This problem of demarcation forced Husserl to reformulate his ideas on the self and
on self-awareness, and he consequently developed a theory of the self as the pole of experience.
This ego-pole allows a possible identification with experiences and makes the stream of
consciousness ‘mine’ (Husserl 1973a, 219; Bernet et al. 1996, 191). Yet, Husserl did not think of
this ego-pole as a substance, nor as a higher-order element of identification. The ego-pole should
be distinguished from Kant’s ‘I think’, inasmuch as it is not a transcending substance or inner
agent outside of the stream of experiences. It just determines that the experiences I experience
are mine (Husserl 1973a, 307). What does this mean exactly?
Husserl claimed that all consciousness is self-consciousness. This is indeed the first step to
the solution of the problem. The pure ego (das reine Ich) is the centre of experiences and it
remains as such after the phenomenological reduction (Husserl 1983, 190-191). Whereas Hume
and the early Husserl had argued that there was no self, only a bundle of perceptions, the later
Husserl would say that it is within the perceptions that the self resides, namely under the form of
self-consciousness. This ‘pure ego’ is the centre of activity, passivity, and affection. The self-
awareness of higher levels of the self, like the person or the ‘empirical self’, but also higher
levels of self-reflection are all grounded on this basic self-awareness within the stream of
consciousness (Husserl 1973b, 275; Bernet et al. 1996).
In order to understand how consciousness can be self-consciousness, and how the self can
be a stream of consciousness, Husserl’s ideas on temporality should be discussed. Husserl firstly
differentiated between objective and subjective time (Husserl 1973a, 19). The first is the

2
The distinction between an egological and a non-egological theory of consciousness was introduced by
Gurwitch (1941). The first argues that every form of consciousness of something is a consciousness for
someone. There is an object, an experience, and a subject who experiences (Zahavi 2000, 56). The non-
egological position, on the contrary, denies that every experience is for a subject (Strawson 2000).

12
empirical or measured time. The second is the temporality that is pre-empirical and non-
measurable. It is the temporality of acts, sensations, and appearances. It is an absolute, pre-
phenomenal flow of time (Zahavi 2010a, 524). This flow of time includes three ‘moments’. The
first moment is the primal impression (Urimpression), which is narrowly directed toward the
now-phase of an experience. Secondly, the ‘retention’ provides us with a consciousness of what
we just experienced. It is a consciousness of the just elapsed phase of the object of experience.
Thirdly, there is a ‘protention’, where consciousness is emptily directed at what is possibly going
to be experienced (Zahavi 2010a, 321). These three together constitute ‘inner time
consciousness’ (Zahavi 2010a, 524), which for its part grounds our consciousness of the objects
of experience. The identity of an object is the result of an original unity, namely the continuously
passing flow of ‘multiplicities’. All forms of synthesis, Husserl wrote, are in the end based on a
final synthesis that happens entirely passively, through consciousness of internal time (Husserl
2012, 44). It is this inner time consciousness in which all different temporal appearances of
objects “run their course” (Husserl 2001a, 172). Besides the necessary temporal structure for the
experience of objects, inner time consciousness is also fundamental for self-awareness (Fuchs
2013d). It is through the retention that I can be aware that the experience I have just had is mine
and is combined with the experiences I am having at the moment, and it is through protention,
that it will be related to my experiences to come. Husserl can therefore claim that “to be a subject
is to be in the mode of being aware of oneself” (Husserl 1973b, 151).
According to Husserl, Kant restricted his investigations to the study of spatio-temporal
objects, while it would have been more interesting to turn towards the experiential subject.
Husserl wrote: “Thus, his question is only this: What kinds of syntheses must be carried out
subjectively in order for things of nature to be able to appear, and thus a nature in general. But
lying deeper and essentially preceding this is the problem of the inner, the purely immanent
object-like formation and the constitution, as it were, of the inner world that is, precisely the
constitution of the subject’s stream of lived-experiences as being for itself, as the field of all
being proper to it as its very own.” (Husserl 1983, 171) And it is indeed this direction that
Husserl and the phenomenological tradition after him have followed.

1.1.2 Minimal self

‘Minimal self’ is a term describing the most basic or core self, which is claimed to be
foundational for every other kind of self. This means that there is a form of minimal self-
awareness that precedes every explicit or reflective self-awareness (Zahavi 2008). The term is
mostly present in Zahavi’s work, who used it to describe the pre-reflective self-consciousness

13
Husserl aimed at. The concept of the minimal self offers an integration of both Husserl’s early
non-egological and later egological views. This prolific concept has received much attention
over the past decades, both within phenomenology and in psychopathology. Further on it will be
made clear that it is this self, and particularly the way in which Zahavi has elaborated it, which is
claimed to be disturbed in schizophrenia. Moreover, towards the end of this subsection, it will be
argued that Zahavi’s understanding of the minimal self is not the only one, and certain aspects of
self-awareness, like embodiment, have been added by other authors. Before venturing into more
detail, it should be clarified what awareness precisely means, as the minimal self is described as
the minimal form of self-awareness.
Awareness means that I am consciously intending an object of my experience. I perceive a
tree; therefore, I am aware of the tree. This is object-awareness. Is object-awareness a sufficient
condition for self-awareness? Jean-Paul Sartre would famously argue that it is not. He
demonstrated that I could only reflectively become aware of my self or my I (Sartre 1957, 53).
Only by adopting a distancing and objectifying attitude to my experiences, will an ego appear
(Sartre 1957, 44). And this reflected self would have little to do with the reflecting self. The
reflecting self that we are interested in, the self as subject rather than object, would escape
(Zahavi 2008). 3 Sartre claimed that the self as such is superfluous (Sartre 1957, 40).
Furthermore, although it may seem that a self could unify our perceptions (as Kant argued), there
is no need for any active connection, as these experiences are already unified as unity of the
temporal flow. Sartre then concluded that a phenomenological investigation leads to self-
awareness, not to the self.
Sartre’s position clearly shows the importance of dealing with both egological and non-
egological’s arguments. Zahavi counters Sartre’s non-egological view by claiming that a certain
self-centrality is still necessary in order to solve the issue of the demarcation from the other. It is
not yet the strong substantive ego Sartre criticized that is here at stake, but an ego nonetheless.
This ego is the subjective pole of every experience. What ultimately determines the mineness of
experience is not an independent self, but the way experiences are experienced: they are
originally given to me.
Zahavi defines self-awareness as the basic subjectivity of experience (Zahavi 2000, 59).
What he means by egocentric self-awareness is not a pure self apart from the experience, “but to
be acquainted with an experience in its first-personal mode of presentation, that is, from
‘within’” (Zahavi 2000, 64). The significant turn is that Zahavi does not deny the presence of a

3
It is obvious that a second attempt to reflect on the reflecting self leads to a higher order account of self-
awareness, and this implies an infinite regress.

14
subject, but he understands it as in the experience, as part of every experience. “It is exactly the
primary presence or first-personal givenness of a group of experiences which constituted their
myness, i.e., make them belong to a particular subject” (Zahavi 2000, 64). The question of how I
distinguish my experiences from yours, or how we demarcate self and other, is thus solved by
showing that the experiences are necessarily yours or mine depending on the original givenness.
The mode of givenness of your pain that I empathise with, and of my own pain is very different.
The subjectivity of experience, this minimal self, is not an element we find through
introspection. “To be self-aware is not to withdraw to some self-enclosed interiority. It is not to
interrupt the experiential interaction with the world in order to turn the gaze inside” (Zahavi
2000, 64). Self-awareness is in the world: “Subjectivity is open towards and engaged in the
world, and it is in this openness that it reveals itself” (Zahavi 2000).4
However, if the self belongs to each and every experience, a problem arises. All
experiences are different, but the self is supposed to remain the same. How is this possible with
the kind of experiential self-awareness Zahavi just described? In order to account for this, he
turns back to Husserl. According to Husserl, the ego must indeed be distinguished from the
experiences in which it lives, but it cannot be independent of these experiences. Therefore, he
claims: the ego is a transcendence, because it transcends the discrete experiences. Yet, the ego is
a transcendence in the immanence, because it only transcends each and every single experience
while remaining within the experiences or within the immanence (Husserl 1973a, 246). Thus,
only a phenomenological investigation of a sequence of experiences, of a plurality of
experiences, is capable of showing the minimal self.
Marbach expands this approach, and argues that the modification of intentional acts, such
as remembering or imagining, also provides the opportunity to analyse the self. In other words, it
should be possible to designate what changes and what remains in this plurality of acts (Marbach
2000, 87). The self supposedly remains identical whether I perceive, remember, or imagine a
house. The self we are searching for is indeed the point of reference of all these intentional acts,
or what Husserl called the ‘zero point of orientation’ (Husserl 1973a, 116, 372). And this is
indeed what Zahavi described as the subjectivity of experience.
Hume’s argument of temporal gaps (such as dreamless sleep, coma,…) becomes irrelevant
for self-awareness. It would only be a problem if we claim that the minimal self is defined
through the contiguity of experiences. Following Husserl and Zahavi, contiguity is not essential.
What is essential is that all conscious experiences are necessarily given to me. “Even though the

4
It will be clear further on that this description of self-awareness fits Neisser’s and Gibson’s ecological self.

15
experiences are unified, this unification is not due to the synthesizing contribution of the ego; on
the contrary, such a contribution is superfluous since the unification has already taken place in
accordance with intra-experiential laws” (Zahavi 2011, 35). The experiences are unified because
they are all given to me, not because they show an inter-connection with each other (Zahavi
2000, 68).5 Based on the previous brief overview, it can be argued that both egological and non-
egological arguments are valuable, however following Zahavi’s account, a basic self within our
immanence can be pinpointed. This basic or minimal self is not a reflected or objective self, but
the subjectivity of our experiences. Moreover, it is not restricted to transcendental philosophy,
but also plays an important role in both developmental psychology and psychopathology. Before
turning to those lines of inquiry, it could be interesting to examine Zahavi’s minimal self a bit
further.
The minimal self has three interwoven characteristics that distinguish it from other forms
of self. The first is that it is pre-reflective self-awareness. The second refers to the first-person
perspective. And the third relates to temporality.
The minimal self is pre-reflective, inasmuch as it is the necessary condition for self-
reflection and, simultaneously, it is not reflective itself. It does not require a meta- or higher-
order position, as it has been argued when introducing Sartre’s description of self-awareness.
The second characteristic is the ‘first-person perspective’. Zahavi offers clear insight into
the quality of this concept: “… when I taste single malt whiskey, remember a swim in the North
Sea or think about the square root of 4, all of these experiences present me with different
intentional objects. These objects are there for me in different experiential modes of givenness
(as tasted, recollected, contemplated etc.)” (Zahavi 2010b, 3). Although all these experiential
modes are very different, they have something in common, namely, they are presented to me and
I experience this givenness as mine. What makes them for-me is not their content or a quality,
but it is essentially the first-personal presence of experience. The for-me-ness of every
experience also accounts for the epistemic asymmetry of experiences, that is to say, the reason
why these experiences are my experiences, and not yours, and the other way around (Zahavi
2008, 122). When looking back at Hume’s famous passage, where he claims not to find any self,
he now seems to clearly overlook that all the experiences and perceptions “of heat or cold, light
or shade, love or hatred, pain or pleasure” (Hume 2003, 180) are given to him, solely presented
through his first person perspective (Zahavi 2008, 126).

5
Zahavi’s argument risks circularity. What determines that an experience is mine, is that it is given to me. The
‘to me’ already supposes that I recognise an experience to be mine. The issue will be disentangled in Chapter 2.

16
 The third aspect of the minimal self relates to temporality. The temporal structure of
consciousness, or what Husserl called inner time consciousness, has been briefly outlined above
(Husserl 1966b). Within that framework, the kind of temporality that relates to the minimal self
is implicit temporality, which is notably the kind of temporality that “runs with the movement of
life, unfolding through the processes of embodied activity” (Fuchs 2010a, 558). Fuchs described
it as follows: “Even in its most basic forms, consciousness is constituted as the duration or
extension of awareness that spans succeeding moments and thus establishes a fundamental
continuity” (Fuchs 2010a, 558). However, the continuity is secondary to the unifying function of
self-awareness itself.
It should also be added that, depending on the author, other aspects are attributed to the
minimal self. So far, Zahavi’s description of the minimal self as an essential experiential
dimension has been employed as guideline of this inquiry. Yet, three more elements could be
included in the discussion: embodiment, self-affection, and the ecological self. These three
strongly relate to each other, and they are particularly relevant for the later concept of self- or
‘ipseity’ disorder in schizophrenia. They are less prominent in Zahavi’s understanding of the
minimal self, though. It is hence helpful to clearly distinguish between Zahavi’s concept of the
minimal self, and the minimal self as referred to by other authors, for example Fuchs. 6 It is clear
that the minimal self is not a substance independent from experience. However, it is not a ‘view
from nowhere’ either. Husserl’s reference to the ‘zero point of orientation’, as previously
introduced, does not entail a solipsistic free-floating spirit, but a concrete subject in relation to
others and the world. Following Fuchs, our primary way of being self-aware and having first-
person perspective on our experiences is through embodiment. Embodiment stands for the
combination of our active interaction in the world (Ich kann) and of the passive being affected by
the world. Our body is the sedimentation of particular capacities and habitualities. On the other
hand, it also limits and constricts our field of interest, our world of action. 7 The body enables and
restricts our conscious experiences and thus, determines our self-awareness a priori. The body
does so in the realm of the pre-reflective, as no explicit reflection or distance is needed in order
to experience ourselves as this body. “The subject body functions as the medium and background
of our experience” (Fuchs and Schlimme 2009, 571). Only secondarily, when we focus and
reflect on our body, we do experience it explicitly as a body. We become somewhat distant and

6
This different appreciation or definition of the minimal self has implications for psychopathology and it will be
relevant further on in order to evaluate the adequacy of the minimal self as a concept for the psychopathology of
schizophrenia. See, for example, Fuchs’ article (Fuchs forthcoming) on the diachronic unity of the self, and in
particular on the role of the body for basic or minimal self-awareness.
7
An intriguing illustration of embodiment restrictions will be discussed in the subsection on developmental
psychology, and, more specifically, on primary and secondary intersubjectivity.

17
distinct from it. But then again, the subject experiencing this distance towards its own body is
still embodied, still pre-reflectively aware of its own subject-body (Leib) although it might
experience its object-body (Körper) as different.
Embodiment, furthermore, incorporates self-affection. Consciousness is always affected by
itself and it is affected by itself through the body (Merleau-Ponty 2005, 496). We sense the
objects we touch, and, simultaneously, we sense ourselves in the touching. “At the root of all our
experiences and all our reflections, we find, then, a being which immediately recognizes itself,
because it is its knowledge both of itself and of all things, and which knows its own existence,
not by observation and as a given fact, nor by inference from any idea of itself, but through
direct contact with that existence” (Merleau-Ponty 2005, 432).
Yet, consciousness is not just self-affection. It is embodied and therefore, it is in the world.
The reference to the ‘ecological self’, in particular, is a way to indicate that the basic self is a self
in ecology, that is: situated, embedded, in dialogue, in interaction. The term stems from
developmental psychology, where infant research has led Neisser (1988; 1995) to support such
an ecological condition of the self. 8 Along similar lines, Gibson (1987, 418) has written:
“Oneself and one’s body exists along with the environment, they are co-perceived”. The
ecological self is then embedded into “its lived space and lived world which presents itself as a
field of possibilities, affordances, barriers or obstacles” (Fuchs 2010a, 550). The ecological self
is thus a self interacting with the environment and being aware of doing so. It is the embodied
form of pre-reflective self-awareness or the ‘subjectivity of experience’. Further on in this
dissertation, how developmental-psychological researchers can conclude the existence of an
ecological self will be extensively discussed, and how bodily processes like proprioception
develop and still play an important role in adult life for basic self-consciousness or for the
minimal self. It will be argued, most importantly, that the interaction with others (and
particularly imitation) is the essential condition for the further development of self-
consciousness.
For the time being, it is important to distinguish Zahavi’s description of the minimal self
against the background of other authors’ account of minimal self-awareness, especially in
reference to the role of embodiment. Nevertheless, Zahavi’s account of the minimal self deserves

8
Neisser’s own extended definition: “An ecological self is an individual who is, and perceives herself to be,
located at a given place (or moving along a given path) in an extended environment of surfaces and objects. She
has, and perceives herself to have, an extended body that is capable of interacting with the environment in a
purposeful way. Those interactions are, and are perceived to be, relevant to her own needs and satisfactions –
including the satisfaction that comes from purposive action itself” (Neisser 1995, 19)

18
full attention at this stage due to its role in the current phenomenological approach to
schizophrenia.

1.1.3 Extended self

The expression ‘extended self’ is used to describe the self or selves which do not fit into
the description of the minimal self. These selves might nevertheless play a vital role in our lives.
The minimal self is thought to be foundational for all other types of self, inasmuch as it is the
necessary condition of experience (Zahavi 2008). However, Strawson (1999, 100) has famously
listed a variety of types of self.9 The main question is whether or not these different selves are
distinct entities that somehow constitute our self and self-experience. It is relatively easy to argue
that the selves are just different moments of an overarching self. It is in this last sense that the
term ‘extended self’ is used here, meaning by that, the overarching cluster of selves which
cannot count as minimal.10 Two main types of extended self are worth discussing here.
The ‘reflective self’ is the self as an object of our reflection. In this regard, we thematically
think of the self that we are. As Sartre has explained, the reflective or reflected self is object-like
and it should be distinguished from the I-consciousness or the reflecting self. Nevertheless, the
reflected self offers a way of experiencing our self, for example during introspection. We are
able to think about our actions, both retro- and prospectively. We are even able to value
ourselves through the reflection of our activities or desires. The reflective self requires distance
from a given situation and interruption from the immediate connection with the surroundings.
Reflecting on oneself also entails de-centring ourselves (Summa 2014a). We are, during the
reflection, not immediately experiencing the world from our perspective, at least not explicitly.
Reflection is indeed a higher-order move, distancing ourselves from the ‘lower’ or fundamental
level of being involved in the world. To break it down: the reflected self is the self we think we
are. We are not constantly reflectively conscious of ourselves. This would impede our fluent
activities. Our self is articulated during internal observation or through reflection in moments of
emotional stress, in philosophical inquiry, or when we are confronted with unusual situations that
require more than spontaneous interaction. This, of course, does not mean that we are not
conscious or self-aware during unreflective moments.

9
The cognitive self, the conceptual self, the contextualized self, the core self, the dialogic self, the ecological
self, the embodied self, the emergent self, the empirical self, the existential self, the extended self, the fictional
self, the fullgrown self, the interpersonal self, the material self, the narrative self, the philosophical self, the
physical self, the private self, the representational self, the rock bottom essential self, the semiotic self, the social
self, the transparent self, and the verbal self.
10
The term ‘extended’ is sometimes used in cognitive science to describe how our minds are ‘extended’ through
the use tools, like a walking cane or technology (Clark and Chalmers 1998). In this introduction, I follow Zahavi
(2008) and Gallagher (2000a) while distinguishing between minimal and extended self.

19
 The second type of extended self that should be mentioned here is the ‘narrative self’.
Narratives are the stories we tell each other, and in order to understand or use those narratives, a
person has to be capable of understanding verbal reports about one’s own or others’ feelings,
thoughts and motives (Fuchs 2010a). There are distinct views on what the role of narrativity is
for selfhood, but they all share some basic ideas. As Marya Schechtman has pointed out, an
essential part of all narrative views on the self is their rejection of the reductionism of subjective
life, an intention many philosophers share. Central elements in the narrative views are meaning
and significance, concepts that are easily lost in scientific reasoning about the self.
Consequently, narrativity seems to be a good way of capturing how we experience subjective life
as meaningful (Schechtman 2011). Another common feature of narrative approaches to the self
is their focus on values. What we experience as good or bad, as reasonable or as senseless is
understandable in a context, in a shared story. Moreover, narrative approaches share the element
of interaction with others. Narratives are not only considered as stories we tell ourselves about
who we are, but also as stories others tell about us, and that we tell about others. My narratives
are interwoven with those of others, we are each other’s ‘co-authors’.
In general terms, the narrative approach to the questions whether the self exists and how to
define it would maintain that the self is inherently narrative: we experience it through narration.
We characterize events, actions and intentions of ourselves and others within a context of
narrativity. We evaluate moral values in such a narrative framework as well. This does not mean
that we necessarily make those moral values or the background narratives explicit. “This view
does not demand that we explicitly formulate our narratives (although we should be able, for the
most part, to articulate them locally when appropriate) but rather that we experience and interpret
our present experiences not as isolated moments but as part of an on-going story” (Schechtman
2011, 398). We ‘live’ our narratives and understand our lives that way. “Stories are lived before
they are told—except in the case of fiction” (MacIntyre 1985, 197).
From a psychological perspective, basic narrative competency is taken to be an important
developmental milestone (Bruner 1997; see also Nelson 2003, 21-29). Through narrativity, we
can understand ourselves as extended over time on the one hand, and different from others on the
other hand. The narrative self is the result of an interpersonal interaction, of sharing stories and
of taking part in each other’s stories. It is this kind of self that we usually think about when asked
about who we are. When trying to answer this question, we start to tell the story of who we were
and who we will be. Although the narrative self is probably the most noticeable in any reflection
on the self, it cannot give a complete account of what we are. Indeed, we reach the limits of this
narrative approach as soon as the question is raised how we recognize a narrative to be about us.

20
How do I know that the story I tell and that others tell is about me? I am apparently not able,
through the use of narrative, to identify my experiences and my subjective life with what is
narrated. Prior to narration, I must preliminarily have the ability to differentiate whom this story
is about and whose experiences are being narrated. In other words: “The narrator must be able to
differentiate between self and non-self, must be able to self-attribute actions and experience
agency, and must be able to refer to him- or herself by means of the first-person pronoun.”
(Zahavi 2008, 113) According to Zahavi’s critique, the first person perspective of the minimal
self, the experiential self-awareness, is thus already pre-supposed. A second important limitation
to the narrative approach to the self should be mentioned here: understanding the self as a result
of narratives arguably excludes those parts of self, which are not structured narratively, that is,
which are not goal-directed, not chronologically capable of narration. Narratives are selective by
nature and seem to impose more unity upon our subjective life than otherwise required (Zahavi
2008, 113).
The extended self is therefore a collective term for different kinds of self, whose common
feature is that they are taken to be the result of interactions with the world, with others, and that
they are still relying on the minimal self. The extended self follows from the acquisition of an
allo-centric position, a position towards one’s self that stems ‘from the outside’, from others. The
extended self then concerns a higher level of subjective life, in a dialectical interaction with
others and the world. The distinction between the minimal and the extended self has undoubtedly
its problems, of which a few have already been discussed. Nevertheless, it is in my view
important to discuss the distinction, particularly since, in schizophrenia, only one ‘kind’ of self is
claimed to be essentially affected. In order to effectively frame the main hypothesis of this
dissertation on the role of intersubjectivity in schizophrenia, a thorough assessment of the current
phenomenological hypothesis on schizophrenia as a self-disorder is required.

1.2 Self-disorders

1.2.1 Psychiatric disorders and disturbances of the self

Now that the reader is acquainted with Husserl’s and Zahavi’s phenomenological
approaches to the self, and now that different types or layers of the self have been distinguished,
the investigation can turn to the psychopathology of the self. Psychopathology as a field
indirectly opens a wide variety of philosophical questions and answers, arguments, and examples
– most of which are uncommon in everyday life. A number of psychiatric disorders can be linked

21
to the previous discussions on the self . 11 Generally speaking, mental illness refers to those
situations in which a person and possibly his surroundings suffer from a condition that has an
impact on the person’s psychic wellbeing, including cognitive functions, affectivity, conation12,
or behaviour. The ‘self’ is a valuable concept within this context. Unsurprisingly, the psychiatric
clinical field has often been delved into while hunting for clues in philosophical discussions. The
validity of philosophical claims is often tested by searching for invalidating counterexamples.
One way of finding one is through imagination. If something is imaginable, it might be possible,
so the argument goes, and thus it could function as an invalidating counterexample. Another way
is turning to psychopathology. But what exactly should one look for, when turning to the clinic?
More specifically, what does the self have to do with mental illness? Several psychiatric
disturbances and disorders that refer in different ways to the self can be discussed here, including
depression, anxiety, personality disorders, and dementia.
Some preliminary questions should, however, be raised. Before moving on to the
psychiatric disorders, it is worth asking whether or not the self is affected also in the case of
somatic illnesses. In case of severe pneumonia, a person may be coughing, having fever, feeling
weak, and somnolent. The sick person is not able to perform usual activities. They may not be
able to read or think the way they normally do. They are restricted in their normal being and the
feeling of sickness might even give them a different feeling of being. Clearly, nobody would
claim that the self of these people is disordered, that their self is sick, or that they suffer from a
changed sense of self. But, it is somehow clear that even a somatic illness has an impact on
aspects of the self. For instance, the sick person cannot be him- or herself, meaning the one who
does particular activities, such as a profession. At least one aspect of being a self has been
affected, their (professional) personhood. But, as previously clarified, this is only one part of
being someone, and it seems to have little to do with the phenomenology of self-awareness.
Psychiatric disorders, on the contrary, may have deeper impact on other aspects of the self,
which are considered to be more essential for selfhood. The different disorders that are
highlighted here help illustrate some common and some distinctive aspects of the self. Through a
particular malfunctioning, a weakening or an alteration, a specific aspect of the self is articulated.
It will become clear later on, that it is a special kind of self that is involved in schizophrenia.
The first condition to be investigated here is major depression, which is one of the most
prevalent psychiatric disorders. A depressive patient may experience strong feelings of guilt, of

11
I use the terms ‘psychiatric condition’, ‘mental disorder’, and ‘mental illness’ without further nosological or
aetiological claims. For a discussion of the (in)adequacy of these terms, see the accounts of Häfner (1987),
Wakefield (2006), Schramme (2010) and the debate opened by Phillips (2012a; 2012b).
12
‘Conation’ refers to those mental aspects related to motivation, strive, drift, impulse, and will.

22
shame, and of a loss of self-confidence. The subjective worthlessness, emptiness, and anxiety of
the patient may become so strong that one develops a death wish. Obviously, the condition
differs in intensity from the kind of sadness and discomfort everyone may experience to a certain
degree. A whole change arguably affects the patient. In the traditional description of
melancholia, and its contemporary interpretation, many references to alterations of the embodied
self can be found. “In melancholia, the body loses the lightness, fluidity, and mobility of a
medium and turns into a heavy, solid body that puts up resistance to the subject’s intentions and
impulses. Its materiality, density, and weight, otherwise suspended and unnoticed in everyday
performance, now come to the fore and are felt painfully” (Fuchs 2005a, 99). The body of the
depressive patient, instead of being a subjective centre of possibilities, can become more and
more objectified. “To act, patients have to overcome their psychomotor inhibition and push
themselves to even minor tasks, compensating by an effort of will what the body does not have
by itself any more. With growing inhibition, their sensorimotor space is restricted to the nearest
environment, culminating in depressive stupor” (Fuchs 2005a, 99). This can result in not being
able to be moved or affected by things or persons, thus disturbing interpersonal affectivity.
Patients may experience themselves and their surrounding becoming less present and less real
than before. Patients may also experience “the feeling of not feeling” (Fuchs 2005a, 99). Clearly,
the depression label covers a mixture of afflictions, from the ordinary feelings of sadness to
depersonalization and the development of delusions. Within this spectrum, the self can be
entailed in different degrees. One may argue that the minimal self as such is unchanged, as
patients still remain implicitly aware of being themselves. In the case of melancholia, the
embodied aspect of the self can however be disturbed. Based on Zahavi’s account, this would
mean that the minimal self is not necessarily affected. However, if one was to follow Fuchs who
integrates embodiment into minimal self-awareness, melancholic depression may well be said to
affect the minimal self. On the broader level of the extended self, namely of reflective and social
self, self-confidence is also clearly affected.
Anxiety disorders are another class of clinical disorders where the self can be affected.
Contrary to ‘normal’ anxiety, in clinical cases anxiety does not seem to go away. These feelings
of worry interfere with normal life and cause the person to doubt and lose self-confidence. This
is also the case in phobias, where there is a concrete fear for a particular object or situation, but it
goes even further in the panic disorder. Mostly, people suffering from this condition experience
panic attacks and the worry of having new panic attacks weakens their self-confidence. At any
given time, the patient may suddenly be overwhelmed by such a panic attack. It seems only
logical that the uncertainty of the timing of the next attack, as well as of the cause or the

23
triggering factors, intensifies the suffering even when there are no attacks. Again, the self-
confidence of the patient can lose its solidity, as the patient might question his or her own
decisions and previous meaningful life events in order to clarify and understand one’s own
experiences. During panic attacks patients often describe experiences of derealisation and
depersonalization, as these attacks are often incomparable to other feelings patients may have
already had. A condition such as the panic disorder or generalized anxiety disorder may cause a
person to doubt his or her own identity, life goals and on a narrative level, it may undermine the
constructed certainties that ground one’s own identity and personality.
An impact on the self can also be detected in different personality disorders. Common to
these disorders is that they are characterized by an enduring dysfunctional pattern of behaviour,
cognition, and experience, which are present in different contexts and moments. Such disorders
usually develop early on, mostly during adolescence, and become manifested in early adulthood.
Both for patients and, often, for their relatives, these disorders cause distress and suffering. Otto
Kernberg (1985), famous for his theories on borderline and narcissism, remarked that the essence
of these personality disorders is twofold: the first is the difficulties in forming an integrative self-
concept; the second is the difficulty in integrating significant others into one’s life. Among
personality disorders, the borderline personality disorder (BPD) is here discussed first. Patients
with BPD display an instability pattern in relationships, often quickly changing their estimation
of others from very good to very bad. They also report difficulties with self-esteem and self-
image, and identity. Patients can for example repeatedly complain of not knowing who they are.
This does not entail to a disturbance on the level of the minimal self, since they experience no
problem identifying their experiences. They, however, seem to have a hard time building a
coherent self-image and identity over time. This is shown in behaviour, with often aggressive
and self-harming acts and impulsivity.
“The rapidly changing affects and moods conspicuous in these patients result in an
incoherence of self-related states and self-concepts. Extreme affective oscillations make them
feel almost like different people, each defined by a particular mood state. The result is a shifting
view of oneself, with sharp discontinuities, rapidly changing roles, goals and relationships, and
an underlying feeling of inner emptiness” (Fuchs 2010a, 561). These patients may not experience
continuity of their personality across time and situations, leading to an unstable self. This is not
only the case for the experience of being the same individual in this moment as before in other
situations, but also for the future. The failure to integrate past experiences with an anticipated
future leads to failing to correctly tell one’s own story. Naturally, such a failure also includes
difficulties in relating to others, notably to the story that others tell of the patient. The

24
problematic and unstable relationships most of these patients have are directly linked to this lack
of attunement to the co-authors of their story. The self affected by BPD is thus the narrative self
and its continuous effort to co-write a coherent story of who we are.
Dementia is the last disorder to be discussed before moving on to schizophrenia. Dementia
is the collective name of the class of neurocognitive illnesses whose main feature is cognitive
deterioration, in particular memory impairment. It is a heterogeneous group and patients with
dementia can experience a variety of symptoms, such as disturbed mood and perceptions,
thought disorders, language difficulties, disturbances of motor activity, and changes of
personality. Alzheimer’s disease is the most prevalent form of dementia. Others include vascular
dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-
Jakob disease. A particular form of dementia depends on the specific symptoms, the clinical
evolution, and the cause. Alzheimer’s disease can be taken as prototypical example. It is argued
that in certain stages of Alzheimer’s, the minimal sense of self is unchanged, while the
autobiographical or narrative level of the self can be clearly disturbed (Summa 2014a). Patients
may not know who they are, who the people around them are, or where they are. But they still
recognize their own thoughts and feelings to be theirs. The perspectival ownership of their
experiences, the sense of agency in their activities is not lost. Thus, in Alzheimer’s disease it
seems that the minimal self, as a pre-reflective experience of being yourself, seems generally
intact.
The previous paragraphs have possibly made clear how some of the most prevalent
psychiatric disorders are related to different aspects or types of the self. In depression, the self is
only secondarily afflicted. Disturbances of the embodied self can be observed in melancholic
forms of depression, so that, depending on one’s understanding of the minimal self, melancholia
could be said to ultimately affect the embodied minimal self. The affective and cognitive
component remains central in other forms of depression. Differently, patients with anxiety
disorder may report symptoms like depersonalization and derealisation during panic attacks.
However, the uncertainty of the origin and hence of when new instances of the attacks might
occur can impact one’s self-confidence and certainty of personal identity. Moreover, in
personality disorders, and in particular BPD, the self-concept plays a central role. The higher
levels of self relying on integration of affects, continuity and stability of time are affected.
Consequently, the narrative self does not develop fully. Lastly, in Alzheimer’s disease, the
minimal self seems to remain unchanged, while higher levels are clearly disturbed.

25
1.2.2 Schizophrenia as a self-disorder
The philosophical descriptions of the self have triggered a renewed interest in the
pathology of the self. Schizophrenia is the most prominent in this field, but as previously
explained, other disorders as well can be described with reference to the self, albeit different
kinds of self. Since schizophrenia is not a philosophical concept, but rather a psychiatric
disorder, from which patients suffer, I will focus on three different approaches to the disorder.
Their selection is justified by their clinical, scientific, and philosophical importance. The first
approach is the mainstream classificatory description of the DSM, which is used for both
research and clinical diagnosis. The second is based on insights from neurobiology and neuro-
imaging, and focuses largely on supposedly underlying mechanisms. The third and last approach
stems from the phenomenological psychopathology that conceptualizes schizophrenia as a self-
disorder. For the purpose of this text, the third account is the most relevant. It will then be
established and at the same time criticized. As a result, this third approach will be scrutinized in
more depth than the other two.
In the mainstream psychiatric discourse schizophrenia is considered as a mental disorder
that can be diagnosed and classified using the Diagnostic and Statistical Manual of Mental
Disorders (DSM) or the International Classification of Diseases (ICD). These classifications list
what are believed to be the specific and sensitive symptoms for all mental disorders. Clinicians
or researchers who want to know whether or not someone suffers from schizophrenia can thus
score the symptoms on this list. The DSM distinguishes different criteria or categories of
symptoms in schizophrenia (American Psychiatric Assocation 2013). The first are called
characteristic symptoms (A) and prior to diagnosis the presence of at least two of the following
is required for at least one month: delusions, hallucinations, disorganized speech, disorganized or
catatonic behaviour, and negative symptoms. Negative symptoms include affective flattening,
alogia (poverty of speech), anhedonia, or avolition. Before the changes introduced by the DSM-
5, only one of these five criteria was taken as sufficient if the delusions were bizarre or the
hallucinations consisted of at least two people conversing with each other. The second category
of symptoms of the DSM (B) refers to social or professional dysfunctioning. This category is a
requirement of many mental disorders. It indicates that something is a disorder as soon as it
disturbs normal life, for example the functioning in the workplace, interpersonal difficulties, or
self-care. A third criterion (C) is the temporal definition: the symptoms have to be present for at
least six months, and active symptoms of category A have to be reported for at least one month.
Further diagnostic specificity is reached by excluding other mental disorders in the same
psychotic spectrum. Schizoaffective disorders and mood disorders should then be preliminarily

26
excluded. Furthermore, the DSM-IV specifies that the symptoms should not be the consequence
of an underlying medical condition or of the use of substances. Lastly, it is worth remarking that
the DSM description differentiates schizophrenia from pervasive developmental disorders, such
as autism.13
One of the recent substantial modifications to the diagnostic classificatory list is that the
subtypes of schizophrenia (the paranoid, the disorganized, the catatonic, the undifferentiated
type) are no longer present. Despite the changes, the DSM does not offer a clear prototype of
what schizophrenia is. Furthermore, its categorical approach sometimes leads clinicians and
researches to doubt the validity of the classification. Since the announcement of the fifth edition
of the DSM, its general approach has been criticised extensively. Its scientific value, its use in
clinical practice, and its supposed a-theoretical background have been questioned (Kendler and
First 2010; Frances and Widiger 2012; Phillips et al. 2012a; Möller 2009). However, to the
disappointment of many clinicians and researchers, the DSM-5 has not brought the innovation it
was expected to bring. This text will not focus any further on this debate, but the reasons why
certain assumptions in the DSM regarding schizophrenia and delusions are simply misplaced
deserve to be discussed. It is no wonder that descriptive psychopathology or phenomenology has
concurrently gained renewed interest. The disappointment engendered by the DSM and its
operational system of diagnosis is one contributing factor.
Schizophrenia remains an enigmatic illness from both a psychological and a neuro-
scientific perspective. Its diagnosis has been mysterious or even controversial since its very first
description (Maatz and Hoff 2014). The concept of schizophrenia has often been at the centre of
fierce criticism. A few of these critical arguments seem to remain bound to the concept still
today. First of all, the anti-psychiatric movement focussed on schizophrenia to prove that all
mental disorders, even the ones that seem most severe, are in fact no disorders at all. Thomas
Szasz famously claimed that there is no such thing as schizophrenia (Szasz 1978). He argued
that, while schizophrenia is claimed to be a disease, it actually lacks every aspect of a
nosological entity. It is merely a label that is wrongly used to exert power over people (Szasz
1978, 27).14
This critique led to a wave of de-institutionalization of chronically ill patients, and it left an
ideological message behind. This message is known as social-constructivism. In today’s form
this view claims that every mental disorder is constructed in a social context (Thornton et al.

13
The changes in the classification and diagnosis of schizophrenia in the DSM-5 are discussed in detail in
(Paulzen and Schneider 2014; Tan and Van Os 2014)
14
Similar criticism was developed and applied in practice by Laing (2010).

27
2009). The famous transcultural studies that showed different appreciation of mental symptoms
among different cultures confirmed this view (Thakker and Ward 1998). Only a few
‘reductionistic’ psychopathologists will discard this idea in general, as it seems clear that a
mental disorder is always something that deviates from normality (Markova and Berrios 2009).
Normality cannot be considered as a universal standard, as it is rather inherently socially and
culturally dependent. Thus, social constructivism, in its lighter version, seems to be
acknowledged today: “Constructivism has been associated with anti-psychiatry activists, but we
should admit that social forces play a role in the creation of our diagnoses, as they do in many
sciences. However, truly socially constructed psychiatric disorders are rare” (Kendler 2016, 5).
The second criticism to the concept of schizophrenia comes from a neuroscientific
standpoint. Neuroscientific researchers claimed that schizophrenia, as based on the DSM’s
description, does not exist. The DSM’s schizophrenia is considered as an artificial gathering of
different pathologies that might have some superficial similarities. According to reductionistic
and realistic views on psychopathology, the DSM offers little more than a faulty diagnostic
construct, while the true disorders are entirely missed by such a categorical classification. 15
However, neurobiological, genetic, and neuro-imaging studies have not yet provided the ultimate
insight that these researchers have hoped for over twenty years now (Van Praag 1999). Genetic
research has shown that a wide variety of genes may play a role in schizophrenia (Van Os and
Kapur 2009). The variety is however so large that it may well prevent us from taking
schizophrenia as one single illness. Such an outcome would be compelling, provided that one
were to accept the assumption that an illness is determined by its genetic or biological underlying
mechanism. Today, attempts are made to incorporate the results of the neuroscientific research
on schizophrenia with psychopathological hypotheses, rather than relying on the DSM’s
classification (Insel et al. 2010).
The second approach to schizophrenia discussed here was developed as an attempt to
answer the difficulties of the DSM’s diagnostic classification thanks to neuroscientific
hypotheses. Van Os and Kapur (2009) argue that the acute psychotic state in schizophrenia is
associated with an increase in dopamine synthesis and release, as well as with resting-state
synaptic dopamine concentrations. The ‘salience hypothesis’ explains the link between these
changes in dopamine neurotransmission and psychotic symptoms (Kapur 2003). This hypothesis
states that psychotic symptoms are the result of an aberrant assignment of salience to stimuli that

15
By ‘realistic’ I mean the views that assume that psychiatric conditions are real, independent entities. They are
independent of the names and labels we give them. They oppose constructivism and nominalism. The
‘reductionistic’ variation of realism is the claim that psychiatric disorders are brain disorders – an idea present
throughout the history of psychiatry, and vivid today.

28
we would normally implicitly ignore or would not pay much attention to. These stimuli become
more important because of the dysregulation of dopamine. Dopamine is assumed to play a role in
motivation and in the rewarding system. When too much dopamine is released in relation to a
certain stimulus, this stimulus will seem more important. It is believed that the patient will
consequently develop cognitive attempts to cope with these new experiences of importance to
stimuli, and thus develop causal explanations that lead to delusions. This hypothesis is
strengthened by the long standing empirical evidence provided by pharmacological therapies
based on anti-dopaminergic mechanisms, which can effectively decrease psychotic symptoms
such as hallucinations or delusions (Meltzer and Stahl 1976; Kapur 2004; Howes and Kapur
2009). In addition to changes in the neurotransmission of dopamine, structural brain imagining
studies show subtle but almost universal decrease in grey matter, enlargement of ventricles and
focal alteration of white matter tracts(Van Os and Kapur 2009). Such a renewed understanding
of schizophrenia would discard the issue of low validity.16 However, the neurobiological model,
based on the dopamine hypothesis, is itself still controversial (Kendler 2014; Kendler and
Schaffner 2011).
Despite all diagnostic and classificatory issues, and despite the anti-psychiatric protest,
most psychiatrists do assume that an entity exists that somehow fits the descriptions of
schizophrenia. As Parnas, Sass, and Zahavi (2013) have argued, the prototypical recognition of
the disorder in the clinical setting seems to indicate that there is some common core to
schizophrenia, beyond possible different aetiologies or causal pathways. 17 In this sense one may
speak of a syndrome or a spectrum of schizophrenia. What H.C. Rümke (1960) has famously
called the ‘praecox-feeling’ and what Karl Jaspers (1948) has described as ‘incomprehensibility’
(Unverstehbarkeit) are classic examples of the supposedly immediate recognition of the
schizophrenic spectrum. However, these descriptions do no justice to the diversity of
presentations of symptoms and experiences that patients describe.
In the light of this clinical recognition on the one hand, and of the struggles to define and
conceptualize schizophrenia on the other, phenomenological psychopathology has committed
itself to overcoming this obscurity. Phenomenological psychopathology attempts to look for
“psychopathological organizers” (Fuchs 2010c) that connect the single features of a disorder.
Over the past twenty years, great efforts have been made to come up with new insights into the

16
The dopamine-hypothesis itself is not new. It is the application of recent results from neurobiology, genetics,
and neuroimaging which have revived the idea. See, for example (Crayton et al. 1968; Meltzer and Stahl 1976;
Spanagel and Weiss 1999)
17
This is a different form of ‘realism’ from the neuroscientific one. This approach also assumes the real
existence of schizophrenia, yet, it is based on clinical recognition and does not make claims on aetiology.
Nevertheless, the constructivist critique applies to it as well.

29
core of the schizophrenic syndrome. Rather than ignoring the social-constructivist critique or the
weak diagnostic validity, these latter have motivated researchers to form a coherent and specific
hypothesis on the presumed common core of schizophrenia. An essential feature of the
phenomenological approach is that it avoids making claims on the supposed cause. In this sense,
it does not commit to any underlying theory of (neuro)reductionism (Parnas et al. 2013). In fact,
the phenomenological project could well be prescribed as a necessary step for any
neuropsychiatric research to begin with. The most prominent result in this direction is the
‘ipseity’- or self-disorder hypothesis (Sass and Parnas 2003; Sass 2014). This hypothesis is
original in the sense that it reformulates long recognized changes in the sense of subjectivity and
specific alterations of consciousness, and that it attempts to test these hypotheses through clinical
experience and empirical findings (Parnas et al. 2005). The hypothesis was strongly inspired by
both the philosophical approach to the self, as discussed earlier, and by the phenomenological
psychopathological tradition.
The schizophrenic disturbance is said to affect the sense of self or self-awareness that is
normally implicit in every act of awareness. Two components play a role in this self-disorder:
hyperreflexivity and diminished self-affection. It is claimed that these seemingly distinct
phenomena have a common ground in the basic disturbance of ipseity. A third component is
identified as a ‘disturbed hold’ or ‘grip’ on the world, although this plays a side role in
psychopathological descriptions (Sass and Parnas 2003, 436).
Hyperreflexivity refers to a phenomenon of disturbed higher order self-consciousness.
What is pathological about it is that it is a non-voluntary, almost forced reflexion on normally
implicit processes: it is a disturbance of the spontaneity and transparency of the body (Fuchs
2010b). The attention of the patient is focussed on these processes that are otherwise tacitly
experienced as part of oneself (Sass and Parnas 2003; Sass 2003; Fuchs 2010b). It is not just a
more intense awareness of something, but rather an “operative hyper-reflexivity” (Sass 2001,
262). Such a condition has been described as “a popping-up or popping-out” of phenomena that
belong to the tacit background of our experiences, such as basic sensations (Summa 2014a).
These phenomena become strange, alienated or even objectified. Hence, hyperreflexivity is an
involuntary tendency that disturbs the natural way of acting, interacting, and experiencing.
Episodes of hyperreflexivity are recorded also in some patients’ descriptions of their experience.
However they can be observed affecting also basic activities of human life. “At times, I could do
nothing without thinking about it. I could not perform any movement without having to think
how I would do it” (a patient quoted in Fuchs 2010b, 247). What is normally an unproblematic

30
encounter with others or an everyday task might become a frightening cluster of elements that
the patient is forced to reflect upon, hindering the smoothness of the interaction or task.18
The second component of the ipseity-disorder is the loss of the sense of self or a
diminished self-affection. This means that there is a decline in the experience of being a “subject
of awareness or agent of action” (Sass 2014, 6). As previously pointed out, we have an implicit
feeling of being at the centre of our own experiences, a certain perspective on the world and on
others, with no need for further introspection (Fuchs 2010a, 549). The schizophrenic patient
might instead experience an altered self-awareness in his own experiences. A different
description of this refers to a diminished ‘sense of ownership’ (Gallagher 2012, 130-132). Parts
of the self that are usually experienced without the faintest doubt seem to become strange and
alienated. For example thoughts, feelings, sensations, or intentions can become objectified or
spatialised (Stanghellini and Lysaker 2007, 165). Thoughts can be experienced as not-mine, as
inserted (by others), or might have the characteristics of an object in the sense that they are
perceived rather than actively thought of by the patient (Stephens and Graham 1994). Besides a
diminished sense of ownership, there can also be a weakened ‘sense of agency’ (Gallagher
2000b). Analogously to the sense of ownership, the sense of agency is the implicit and
immediate recognition of one’s presence in (motor) activity. This indicates more concretely that
patients may not recognize that they are the agent responsible for the movement of their body
(Fuchs 2010b).
Unfortunately, within the ipseity-disorder hypothesis, it is not entirely clear how these two
components actually relate. Is hyperreflexivity the consequence of a loss of the sense of self?
Hyperreflexivity would then be some sort of compensatory mechanism attempting to do the
work of the implicit processes explicitly. Interestingly, one could claim causality in the other
direction as well. Either way, also in voluntary non-pathological cases, hyper-reflecting is
connected to the dissolving of the implicit experience of the naturalness of one’s own
experiences. 19 For the moment, it seems best to describe the two features interdependently
avoiding to claim that one is the cause and the other the consequence. It is important to note,
however, that during certain periods or for certain patients either component can be more or less
present, and both of them might even be absent (Sass 2014).

18
I think it is important to acknowledge that ‘normal’ phenomena like doubt, self-reflection, and ‘overthinking’
are unspecific and are present in normal subjective experiences as well. See Fuchs’ accounts (2010b) of similar
forms of hyperreflexivity in disorders which are traditionally termed ‘neurotic’. It might not be easy to
distinguish hyperreflexivity from these phenomena.
19
For an elaboration of the connection between philosophical reflection, hyper-reflecting, and madness, see
(Kusters 2014).

31
 The third component is the loss of grip on the world. Sass and Parnas write that the two
elements of the ipseity-disturbance are “accompanied by distinctive abnormalities of the salience
and stability of the objects and field of awareness that we refer to as disturbed perceptual or
cognitive ‘hold’ or ‘grip’” (Sass and Parnas 2001, 348). This third component is the least
elaborated, although present in most of the phenomenological descriptions of schizophrenia. Sass
writes, for example: “Disturbances of spatiotemporal structuring of the world, and of such
crucial experiential distinctions as perceived-vs-remembered-vs-imagined, are grounded in
abnormalities of the embodied, vital, experiencing self” (Sass 2014, 6). The loss of grip on the
world involves then perplexity and a loss of common sense. Other than that, this component of
the ipseity-disorder remains mostly enigmatic and its relation to the other two components is
unclear. However, it will be most relevant for this inquiry into the intersubjective dimensions of
schizophrenia.
The above outlined contemporary phenomenological view on schizophrenia is deeply
rooted in the psychopathological tradition. Psychopathologists as Karl Jaspers, Eugène
Minkowski and Wolfgang Blankenburg have worked on different aspects of schizophrenia
within their own historical context and they have all described alterations we find in the current
hypothesis. Contemporary authors often refer to these famous psychopathologists of the
twentieth century. The ipseity-disorder is then clearly not entirely new, but rather has significant
historical roots. Even earlier than the twentieth century, studies have attempted to describe what
is now called the loss of sense of self, among others by Störring, Pick, and Berze (Fuchs 2013c).
The resulting descriptions somehow still fit the contemporary model, although they use a
different terminology and presuppose a manifold of underlying aetiologies: ego vitality, ego
activity, ego consistency and coherence, ego demarcation, and ego identity (Scharfetter 1995).
The ipseity-disorder hypothesis differs from the two previous approaches to schizophrenia
in many ways. First, as a phenomenological description, it focuses on the experience of the
patients themselves. Secondly, it does not treat the symptoms as object-like criteria, but
emphasizes the patient as a person, as a whole. Thirdly, it limits causal assumptions by
remaining within the framework of consciousness and experience. In other words: it does not
make claims on aetiology, but is still able to search for a more basic or core disturbance.
A good example of these differences is provided by the subtle approach to prodromal or
primordial stages of schizophrenia. The prodromal stage of schizophrenia is believed to be an
important indicator of what the core disturbance could actually be (Parnas and Handest 2003).
Uninfluenced by complicated compensatory reactions or ‘sequelae’, it is investigated to find the
first pure manifestations (Sass and Parnas 2001, 352). From a clinical standpoint, the focus on

32
prodromal stages is important, in the sense that early treatment of whatever kind could improve
the prognosis. It is of course an ethical question to what extent one would want to prevent or
treat a chronic psychotic illness, before there has been any psychotic outbreak (Broome et al.
2013). Furthermore, the lack of specificity in the detecting of pre-psychotic or prodromal
schizophrenic stages makes prevention difficult, from both a practical and an ethical standpoint.
However, there are reasons to believe that the phenomenological approach to schizophrenia
could successfully specify early manifestations and experiential anomalies that could as matter
of fact help this prediction (Gaebel et al. 2000).
Based on these premises, a semi-structured interview has been developed that
operationalizes and tries to quantify the qualitative alterations of the underlying model. The main
assumption is that pre-psychotic experiences could be detected by carefully interviewing persons
about their experiences. Many of the interview items concern the loss of the sense of self or
hyper-reflexivity. Studies carried out through the ‘EASE’ (Examination of Anomalous Self-
Experience) show that self-disturbances can be used as specific parameters to discriminate
schizophrenia and schizotypal personality disorders from psychotic bipolar disorder as well as
from heterogeneous samples (Parnas et al. 2005; Raballo and Parnas 2012). The ipseity-disorder
hypothesis is thus not limited to psychopathological reasoning, but has already found its use in
clinical setting and in empirical research.

1.2.3 Which self is affected?

In the light of the philosophical study on the self, one could well ask which model of the
self is advocated by the hypothesis on schizophrenia, and consequently, which part of the self
would be taken as disturbed. As previously illustrated, disturbance or alteration of the self is not
specific to schizophrenia only. Other disorders affect the self in different ways, too. However,
“the identity disorder operates on the level of social self (self-image), with the sense of ipseity
and pre-reflective immersion remaining intact” (Parnas and Handest 2003, 126).
According to the current phenomenological hypothesis, schizophrenia involves disturbance
of the very basic self-experience, namely the diminishment of self-affection, which is sometimes
divided into the ‘sense of ownership’ and ‘sense of agency’. It is also assumed that disturbances
of higher levels or the self, like the narrative self, are less specific or secondary in schizophrenia
(Cermolacce et al. 2007, 707; Sass 2014). Difficulties with personal identity, with interpersonal
relations, or general behaviour, and more seldom phenomena such as dissociation of personality
are not part of schizophrenia alone. These less specific parts of the self-disturbance are often
thought of as the consequence of disturbances on a more basic level.

33
 The disturbed self is then the minimal self, concerning which, as previously discussed,
different philosophers have a different understanding. This also means that a disturbance of
Zahavi’s minimal self could result in something slightly different than when the disturbed self is
Fuchs’ minimal self, with its incorporation of embodiment. Fuchs investigated indeed the
embodied and temporal components of the self-disorder, and the reader might recall that
embodiment is understood as a sensory-motor relation to the world, that is mediated through the
body (Fuchs 2010a, 550). Within this framework, a disturbance of embodiment, also known as
‘disembodiment’, implies a disturbance of the minimal self, namely of this basic sense of self, as
a disintegration of bodily habits that are implicit in our natural and everyday activity (Fuchs and
Schlimme 2009; Fuchs 2010b). Disembodiment goes hand in hand with a loss of pre-reflective
and practical immersion or embedding of the basic self in the world. Through the body, as a
transparent medium, I am directly related to and find myself in the world. This last relation, of
my body to my world, can be called ‘embedded’.20 Furthermore, I am not only bodily related to
the world of objects, but also to others. As the body is related to the body of others, similarly will
disembodiment relate to a disturbance of inter-corporeality, of being embodied beings together
with others (Stanghellini 2009).21
As previously argued, pre-reflective self-awareness, or the minimal self, also implies a
basic temporal continuity. In schizophrenia, symptoms such as thought disorder, thought
insertion, hallucinations, or experiences of passivity can be described in terms of disturbed inner
timer consciousness. “Generally, it can be observed already at the prodromal stages and also as
the illness progresses to chronic states, how patients attempt to compensate for the disintegration
of lived time through the explicit creation of artificial continuity. This primarily includes
‘rational reconstruction’ strategies, the adoption of rituals or the minimization of external
changes as in autistic withdrawal” (Fuchs 2013d). The ipseity-disorder is manifest in temporality
through a weakening and fragmentation of temporal self-coherence, “leading to a fragmentation
of the intentional arc, thought incoherence and major self-disturbances” (Fuchs 2013d, 101) .
In conclusion, it should be remarked that, even though Zahavi and Fuchs emphasise
different aspects of the minimal self, they do agree on the foundational model of the self. It is
this very foundational model that can be found in the current phenomenological approach to
schizophrenia. Fuchs, for example, explains how the minimal form of self-awareness is

20
The term ‘embedded’ derives from the debate on social cognition, where enactivists support the four E’s:
cognition is embodied, embedded, extended, and enactive. It has a strong connection to the previously mentioned
ecological approach of Neisser (1988; 1995) and Gibson (1987, 418).
21
In Chapter 4, I will discuss this relation between an embodied minimal self and intercorporeality in more
detail.

34
considered to be most fundamental, as it remains present in forms of dementia, where
autobiographical memory is lost, or in certain frontal brain damages, where long-term sense for
the future is missing (Fuchs 2010a). The minimal self is “a necessary foundation for the
articulation of a richer or sophisticated, reflective, language-bound, narrative selfhood, with its
representational elements and dispositions” (Parnas and Sass 2011, 525).

1.3 Self and intersubjectivity: developmental psychology and

psychopathology
The previous overview of the current phenomenological approach to schizophrenia shows
that intersubjectivity is only taken to be playing a side role. Only the third component of the
ipseity-disorder hypothesis includes a reference to others, namely to the ‘loss of grip’ as a
disturbance of experiencing the shared world. It might not be a coincidence that this third
component is the least elaborated. Yet, there have been other attempts to describe the role of
intersubjectivity in schizophrenia, especially in recent years. Before turning to these descriptions,
a reference to developmental psychology is required. The reason for this is that, whereas
psychopathology studies how the self becomes disordered, disturbed, or affected, developmental
psychology, studies how the self comes to be in the first place, and how it further develops. In
the following first subsection, three views on developmental aspects of the self and
intersubjectivity will be briefly introduced. Even though these views originate in empirical
research, they offer useful insight into the philosophy and psychopathology of the self. This will
contribute to a better understanding of the ‘ecological self’, which I believe to be an essential
element for the understanding of selfhood. After that, the existing literature on the disturbances
of intersubjectivity in schizophrenia will be discussed, as status quaestionis.

1.3.1 Developmental psychology

Developmental psychology on intersubjectivity is a large research field. It combines theory
and experimental research, for example by use of microanalysis of film fragments of mother-
infant face-to-face interaction. For the purpose of this text, it will suffice to illustrate some of the
most relevant accounts on the development of the self and its relation to intersubjectivity. The
question formulated here is how developmental psychologists understand the emergence of a
(sense of) self and how this relates to intersubjectivity. One may ask, for instance, whether
Zahavi’s minimal self is already present from birth on, or even earlier. Can an infant distinguish
between self and other, between mine and yours? Is this ability acquired, and if so, what role
does sociality play in it?

35
 For a while, a central assumption of many developmental psychologists was that in early
childhood the infant is incapable of experiencing a distinction between self and other or
otherness. This ‘indistinction’ or fusion between me and the other has been described as a
‘syncretic sociality’ (Wallon quoted in Gallagher and Meltzoff 1996, 227) or as an ‘adualistic
confusion’ (Piaget 1981). Only when the infant is old enough (16 months according to Piaget)
and has developed the ability of de-centration, is the infant able to experience the distinction of
self and other. However, Meltzoff and Moore’s (1977) famous imitation studies questioned these
assumptions. They showed that infants imitate facial expressions (e.g. tongue protrusion) from as
early as 42 minutes after birth (Beebe et al. 2003). Why is such early and subtle imitation
relevant for the relation between self and other?
According to Meltzoff, new-borns have the ability to search and find concordance between
themselves and the other, namely between the face of the other and their own face. Infants
monitor and modify their own actions to their intentions, to match the model they perceive. The
infant who first sees the repeated tongue protrusions will show increasingly more attempts to
protrude their own tongue (Beebe et al. 2003, 812). Older infants, up to 6 weeks, are able to
postpone the imitation, leading Meltzoff to conclude they form a ‘representation’ of the other
(Meltzoff and Moore 2002). This means that the infant is already aware of being different from
the perceived other, yet similar as well: when infants modify their own facial movements to
match the perceived facial movements of the other they recognise the other to be ‘like me’
(Meltzoff and Moore 1977; Beebe et al. 2003, 183; Meltzoff 2007). This means that a certain
‘translation’ of visual information to motor-activity is necessary, what Meltzoff calls ‘cross-
modal matching’.
Further inquiry by Trevarthen shifted the focus from imitation to interaction. He claimed
that early infancy imitation, as discovered by Meltzoff, is a manifestation of the ‘human
sympathetic consciousness’, which he believes to be innate, rather than acquired. Infants and
their mothers are ‘in an immediate sympathetic context’ (Trevarthen 1998, 9). This context is
important for the further development of the infant. The context is dialogical. Clearly, infants are
not able to use language to communicate, but they show communication through proto-
conversations (Beebe et al. 2003, 815). The sympathetic connection is immediate, preverbal,
conceptless, and atheoretical. Trevarthen calls it a “delicate and immediate with-the-other
awareness” (Trevarthen 1994, 122). This form of early intersubjectivity is based on the
reciprocal dialogue of expressions and gestures. The proto-conversations are characterized by
their rhythmicity. The microanalysis of filmed face-to-face interaction between child and parent
showed that rhythm, intensity, and form are the key elements in this pre-verbal dialogue

36
(Trevarthen 1998, 5). The early imitation that Meltzoff showed, and the later subtle attunement
in expressions and gestures have a purpose: they promote the reciprocal attachment of child and
parent (Reddy 2008, 60).22
Meltzoff and Trevarthen have therefore claimed that early imitation and proto-
conversations are expressions of the earliest form of intersubjectivity. This means that
intersubjectivity does not require and explicit Theory of Mind or a shift of perspectives. 23 Not
everyone agrees with this last point, however. Stern, for one, argues that imitation and proto-
conversations cannot yet be called intersubjectivity. In his book The Interpersonal World of the
Infant (1985) Stern explains how he understands the development of a sense of self in the infant.
Until around 2 months of age, the infant is in a “presocial, precognitive, pre-organized life
phase” (Stern 1985, 37). During this time, before consistent direct eye contact, the infant
develops some kind of self-organisation, and Stern calls it a sense of emergent self. After two
months, a developmental shift occurs, and the child develops a different sense of self: the sense
of core-relatedness. Four components form the sense of core self: self-agency, self-coherence,
self-affectivity, and self-history. These four elements are integrated into the social subjective
perspective and thereby form the sense of core-relatedness. 24 Stern then claims that real
intersubjectivity only begins around 7 to 9 months, when the child discovers joint attention,
communication of inner experiences, and therefore discovers the other as a self. He characterizes
‘real’ intersubjectivity by three components: joint attention; joint intention; and affective
attunement (Stern 1985). ‘Intersubjectivity’ according to Stern is the sharing of subjective
experience. This sharing is only possible when the infant senses that the other holds or entertains
a mental state that is similar to one that they sense themselves. Only then can one speak of
sharing a subjective experience (Stern 1985, 124). He believes this to be a second important shift
in development. Prior to this moment, the infant-parent interaction is based on and limited to
gestures and other overt behaviour, while it now becomes a matter of subjective or inner
experiences. The infant becomes aware of the experience of the other, of the other’s perspective,
and therefore a “new domain of intersubjective relatedness” emerges, “a new organising
subjective perspective about the self” (Stern 1985, 125). The alteration Stern describes at around
seven to nine months does not change anything to the infant’s ‘core-relatedness’.

22
The enactive interpretation of this early development is discussed in (Fuchs and De Jaegher 2009, 78-82).
23
I will investigate the Theory of Mind in developmental psychology when discussing tertiary intersubjectivity,
and in schizophrenia when discussing the work of Chris Frith in Chapter 3. For now it suffices to say that the
Theory of Mind-paradigm assumes that one develops a ‘theory’ on the mental life of the other in encounters, in
order to asses the intentions, desires, and thoughts of the other.
24
It is important to note that Stern explicitly defines this as a ‘sense’ of self, rather than as a form of knowledge
or a concept of self.

37
“Intersubjective relatedness does not displace it; nothing ever will. It is the existential bedrock of
interpersonal relations” (Stern 1985, 125).25
Joint attention is manifest when the child is able to follow the direction of an indicating
finger towards an object, rather than look at the finger. This means that the child experiences the
other as having a perspective on the objects. Rochat calls this a ‘triangulation of
intersubjectivity’ (Rochat 2001, 136). Children as early as nine months are able to do so, while
there are earlier subtle signs of following the gaze of the mother in a particular direction. Often
young children capable of joint attention will look back at the face of the indicating mother to
see whether the same object was intended as the child spotted (Beebe et al. 2003, 822).
Joint intention implies that the infant understands that the other can perceive my intentions
and I can perceive the other’s. An example of this is when a child wants a cookie the mother is
holding, and makes sounds and gestures to get it. The child knows that the mother understands
these intentions. If not, there would be no purpose in the gestures and sounds (Stern 1985, 131).
Lastly, joint affectivity means that the child regulates and adapts her emotional state in
interaction with the parent. It is the first (and pre-verbal) way of sharing experiences. This was
tested by confronting infants with an object of uncertainty. A strange moving object either
approached the infant, or the infant was attracted to an object for which it had to cross an
uncertain and seemingly dangerous cliff. Children from nine months on ‘checked’ the emotional
expression of the mother before withdrawing or approximating the object. If the mother showed
an uncertain and frightened expression, the child would withdraw and even become upset. If the
mother showed ease and confidence, the child would approach the object and overcome the
uncertainty of the danger. This “social referencing”, as it is called, does not only illustrate the
importance of security in the interaction. It also shows that the child knows that the mother
understands their worries and the infant attunes his or her own to the mother’s affective state and
adapts his or her behaviour to it (Stern 1985, 132).26
“Interaffectivity may be the first, most pervasive, and most immediately important form of
sharing subjective experiences” (Stern 1985, 132). 27 Affect attunement is thus defined as a

25
Importantly, the three characteristics of ‘real’ intersubjectivity arise already in the preverbal phase and they are
still present throughout the development of language skills and verbal interaction (Stern 1985, 128).
26
In another experiment the affective attunement was tested by through the microanalysis of mother-infant
interaction. This showed that both mother and infant adapt the timing, the form, and the intensity of their
expressions to each other (Stern 1985, 132). An example of this: a nine month old girl reached out for a toy, and
once she grabbed it, she let out an ‘ahh’. Simultaneously with the “ahh”, the mother did a shimmy, wiggling her
body with the same activation as the infant’s sound (Beebe et al. 2003, 825).
27
The importance of the disruption of this affective attunement for schizophrenia is discussed in Chapter 3. In
infant research, disruptions of affective attunement by the mother, for example by reacting less intensely than
before, often prompt the infant to interrupt its playing and look at the mother (Beebe et al. 2003, 826).

38
dynamic cross-modal matching of the intensity, timing, and ‘shape’ of affectivity and its
expressions. This matching is perceived as patterns of change that show similarities between self
and other (Stern 1985, 153).
Stern’s description of intersubjectivity is thus a developed form of sharing subjective
experiences of the world with others. Trevarthen called this ‘secondary intersubjectivity’, as
opposed to primary intersubjectivity, which he defines as a dyadic and immediate relation
between infant and mother (Trevarthen 1998). There are physiological reasons why Trevarthen’s
secondary intersubjectivity can only develop from a certain age. Due to motoric and postural
restrictions, the infant is unable to follow the gaze of the mother towards, for example, an object
behind the infant’s back. The boundaries of joint attention are determined by the boundaries of
the visual field (Butterworth 2000).28
These experiments and the theories resulting from them are important for the philosophy of
the self, inasmuch as they account for how the infant’s self emerges and develops. The main
differences between the three developmental psychologists concern what intersubjectivity is,
whether it is innate or acquired, and how it is acquired or how it develops in interaction. For this
text’s purpose, more important than the exact differences between these three accounts are their
ideas on the self. Contrary to the idea that infants experience self and others in an ‘adualistic
confusion’ or as a ‘syncretic sociality’, this research has shown that an early distinction is
present and it can be described as a dialogical or conversational interaction. Infants relate the
gestures and expressions of the conversational partner to themselves, and translate this to their
own motor activity.
A crucial question is whether infants are always already self-aware. Butterworth (2000, 20)
argued that proprioception is a mechanism of self-sensitivity, common to all perceptual systems.
It is through proprioception that the ‘cross-modal translation’ is possible. Proprioception, and
thus a very basic sense of self, is present from the very moment perception is possible, as
perception implies simultaneous proprioception and exteroception. This is a truly ecological
idea: perception is co-perception of self and environment. This does not start two months after
birth, but it is rather present since birth, and arguably even earlier.
In contrast to the ‘adualistic confusion’, Gibson claimed that ego and non-ego are given in
an original synthesis. “Oneself and one’s body exist along with the environment, they are co-
perceived (Gibson 1987, 418). Meltzoff’s experiments reinforce these ideas: through the subtle
process of imitation, infants differentiate between self and the social environment (Butterworth

28
Another important physiological restriction is, of course, brain development.

39
2000, 22). Young infants are furthermore able to differentiate between state changes and object
or environment changes. This suggests that they can differentiate between self and non-self
(Butterworth 2000). The term ‘ecological self’, coined by Neisser (1988), indicates a non-
reflective consciousness, which is clearly present in higher forms of self-consciousness and self-
knowledge as well. As infant research shows, some basic form of self-consciousness has to be
present long before explicit reflective self-consciousness appears, something equivalent to what
Gibson described with the term proprioception.
How do the previous remarks contribute to the definition of the self and its emergence? It
can be argued that there is already a sense of self before the explicit mirror-recognition occurring
at around eighteen to twenty-four months (Meltzoff 1990). Indeed, already in the early imitation
some sense of self through proprioception should be assumed. This ‘primordial’ or ‘embryonic’
notion of self involves a sense of one’s motor possibilities, body postures, and body powers,
rather than one’s visual features. “The new-born infant’s ability to imitate others, and its ability
to correct its movement, which implies a recognition of the difference between its own gesture
and the gesture of the other, indicates a rudimentary differentiation between self and non-self”
(Gallagher and Meltzoff 1996, 227). On its turn, social interaction opens up a world of subjective
experiences, through which the infant develops from a dyadic interaction to a triadic interaction
with the world. All higher layers of the self are, Stern would claim, however built on the same
core self-relatedness. This self-relatedness is called ‘proprioception’ in the theory of the
ecological self; and within the phenomenological discourse of Husserl and Zahavi, the same
element is referred to as minimal self.29 Few additional remarks on the role of the other lead to
the conclusion of this short subsection. Proprioception is undoubtedly a vital element in the
distinction between self and other. Already since birth, and arguably even earlier, infants can be
said to be self-aware in this proprioceptive way. However, in order to develop further self-
awareness and higher levels of self, including Stern’s sense of core-relatedness, the infant needs
the other. It is only in the interaction with the other, and later with the other and the world, that
the sense of self can further develop. The early imitation and proto-conversations show that the
infant’s self develops dialogically or ecologically. This does not entail that the infant is explicitly
aware of others, or able to take their perspective. Only when the child is older, towards the end
of the first year, does he or she experience him- or herself as one among others, who each have
their perspective on the world and their own inner experiences. Joint attention and joint intention

29
Theories built on empirical research of infant development are of course neither transcendental philosophy nor
phenomenology, and it may be confusing to mix up terminology from both fields. However, the characteristics
of the minimal self, as previously described, do match well the basic sense of self acknowledged by these
developmental theories.

40
are only then possible. A necessary condition for such development is that infants experience
themselves to be embodied-with-others (Trevarthen 1994, 122).

1.3.2 Psychopathology of intersubjectivity

This study is not the first to point to the significant role of intersubjectivity in
schizophrenia. A few recent articles have been devoted to the description of some of the
intersubjective deviations of the disorder. However, these attempts are scarce, and either they are
not integrated into a broad philosophical theory on intersubjectivity and the self, or they consider
intersubjectivity to play only a minor or secondary role in psychopathology. Some accounts,
however, do explicitly indicate that the intersubjective disturbances of schizophrenia require
more adequate study, and offer helpful insights for such research. I use these as a stepping-stone
towards a profound study of the phenomenology of intersubjectivity in schizophrenia. Let us
now look at some of these accounts.
Parnas’ and Sass’ accounts on self-disorder have already been discussed. As already
indicated, they assign a secondary role to intersubjectivity. And, as previously explained, the
fundamental alteration is taken to concern the minimal self or pre-reflexive self-awareness, and
other (higher) forms of self, such as the social self, are taken to be affected only secondarily
(Parnas and Handest 2003). However, they also describe a third component of the disorder,
namely a ‘loss of grip’. The disturbed hold or grip typically involves perplexity and a loss of
common sense, Sass (2014) writes. Although Parnas’ and Sass’ vast work on schizophrenia
should be acknowledged as the indispensable source of this text, and I see my own study as an
extension or complementation of their work, it has to be noted that intersubjectivity disturbances
appear to have been neglected. In a recent article on schizophrenic delusions, Sass and Byrom
(2015) call for an investigation of the subjective or lived experience of the delusional patient. 30
However, despite the focus on the subjective dimension of delusions, they overlook the
intersubjective dimension. Interestingly, some psychopathologists and philosophers, like Fuchs
(2015b), Ratcliffe (2015), and Lysaker and Hamm (2015) have explicitly commented on exactly
this point.
Moreover, ‘loss of grip’ is not the only element in Parnas’ and Sass’ accounts, which
suggests a connection to intersubjectivity. Phenomena like transitivism, for example, concern the
self-other demarcation and this is certainly a direct reference to how subjectivity and
intersubjectivity are disturbed (Parnas and Sass 2001). Besides, it is Sass who first used the term

30
In general, this is an approach I am very much in favour of. Neurocognitive approaches to delusions fail to
account for the subjective experience of delusions and therefore risk losing ‘the psyche’ of psychiatry out of
sight.

41
‘quasi-solipsism’ to describe schizophrenia (1994). Nevertheless, other psychopathologists have
devoted more attention to intersubjectivity in schizophrenia. Particularly in the last years,
different phenomenological studies have appeared on the topic, building further on the self-
disorder.31 Notably, two authors have given important contributions in this direction: Stanghellini
and Fuchs.
Stanghellini defines one aspect of schizophrenia as a disturbance of common sense. There
are two meanings to this: first, common sense is understood as ‘coenesthesia’, and the
disturbance is therefore a disturbance of combining all single sensations; secondly, common
sense refers to practical knowledge, and the disturbance of it implies difficulties of know-how
and of understanding “the human game” (Stanghellini 2011, 165). For the purpose of studying
intersubjectivity, the second interpretation of common sense is most relevant. This interpretation
of common sense can be divided into two particular forms. The first concerns the knowledge of
social rules and the particular ways of conceptualizing objects, situations, and other people’s
behaviour. All this is a matter of social knowledge (Stanghellini 2001). The second form of
‘social’ common sense refers to a more pre-reflexive attunement. It is non- or pre-propositional,
and it is considered to be a skill or an ability to make emotional contact with others and relate to
each other’s personal or subjective life (Stanghellini 2011, 165). Stanghellini further remarks
that the derealisation experienced by the schizophrenic person is specific: it is a de-socialisation.
“The interpersonal scene becomes an empty stage on which the main actor is unaware of the
plot, out of touch from the role he is acting, and unable to make sense of what the others are
doing” (Stanghellini 2011, 165). 

On a different note, Fuchs’ articles on intersubjectivity can be read as a refutation of
mentalistic or cognitivistic accounts on schizophrenia. As we will see in Chapter 3, Chris Frith
(1992) formulated an important claim on schizophrenia, based on the paradigm of the Theory of
Mind. This hypothesis, and the subsequent research, indicates that particular symptoms and signs
of schizophrenia concern disturbances of ‘meta-representation’ and ‘self-monitoring’, and these
include dysfunctions in social behaviour and in understanding the other. Fuchs does not refute
the importance of symptoms such as social dysfunctions, but does criticise the underlying
mentalistic approach. 32 What is most relevant at this point, however, is that he refers to the

31
Other articles I will not discuss in this subsection: (Varga 2010; Irarrázaval and Sharim 2014; Sass and
Pienkos 2013a). Pienkos (2015) discusses schizophrenia in the light of intersubjectivity. Her approach has
similarities to my approach in Chapter 3. The reader will notice that the authors and works mentioned in this
section are an important source for that chapter.
32
Fuchs writes that, contrary to the phenomenological approach, the ‘mentalistic approach’ assumes “a
fundamental strangeness and inaccessibility of the other whose hidden mental states, thoughts, or feelings may
only be indirectly inferred from his external bodily behaviour” (Fuchs 2015c, 192).

42
distinction between three sorts of intersubjectivity, as closely related to the forms of
intersubjectivity already encountered when discussing developmental psychology. The first two
forms (primary and secondary) of intersubjectivity have already been discussed in the previous
subsection. Tertiary intersubjectivity, Fuchs (2013a) argues, is a further developed form of
being-with-others where a self-other-metaperspective is achieved. Others can then be considered
as mental agents with beliefs, intentions, and ideas different from one’s own, and as agents who
are aware of one’s own beliefs, intentions, and ideas. Infants thus acquire the ability “to freely
oscillate between an ego-centric, embodied perspective on the one hand, and an allo-centric or
decentred perspective on the other, without thereby losing one’s bodily centre of self-
awareness” (Fuchs 2015c, 195).
Why is this distinction relevant? First of all, the difficulties with tertiary intersubjectivity
correspond to the deficits in perspective taking as assumed in the Theory of Mind. This means
that other forms of intersubjectivity are already present, and might be disturbed instead of only
the higher and more developed form of intersubjectivity. Fuchs indeed argues that in
schizophrenia, like in autism, there is a disturbance of primary intersubjectivity, manifested in a
lack of primary bodily empathy and implicit social understanding (Fuchs 2015c, 199). But he
also relates schizophrenia to tertiary intersubjectivity, as described in the phenomenon of
transitivism and in schizophrenic delusions. Delusions, he writes, are not so much disturbances
of the brain, but of the in-between (Fuchs 2015c, 208). Therefore he concludes that
schizophrenic patients primarily suffer from a disturbance of bodily being-with-others and social
attunement, rather than (primarily) from a deficit of the Theory of Mind.
Fuchs also relates the self-disorder to intersubjective disturbances on the level of implicit
and explicit temporality (Fuchs 2013d). He distinguishes these two forms of temporality and
describes how schizophrenic persons suffer from desynchronisation on both levels.
Desynchronisation essentially means a disconnection with others, a mismatch between the
shared temporal experiences. On the implicit level, this is related to a disturbance of the
protention and to disruptions of what he calls ‘the intentional arc’ (Fuchs 2007, 230). Protention,
as a vital part of inner time consciousness, and the intentional arc with its conative-affective
dimension, become disturbed and fragmented, leading to essential ego-disturbances like thought-
insertion, thought-withdrawal, thoughts-aloud, and passivity experiences. But it also relates to
intercorporal affective resonance between the schizophrenic person and others. Subtle difficulties
in facial recognition, for example, are considered to be expressions of an intersubjective
desynchronisation. Fuchs also describes desynchronisation on higher levels of explicit
temporality, namely in what has been previously referred to as disturbances of ‘common sense’.

43
He thereby immediately connects the self-disorder to intersubjectivity, as he writes that
“schizophrenia always appears as a disturbance of the basic intersubjectivity or contemporality”
(Fuchs 2013d, 84).
Before concluding this introduction into the research on intersubjectivity and
schizophrenia, it is also worth noting that intersubjectivity (and our knowledge of it) may play a
significant role in recovery (Schlimme and Schwartz 2012). I will return to this matter in the
fourth chapter, as it relates to the clinical relevance of this philosophical study.
This brief subsection only illustrated some accounts on intersubjectivity and schizophrenia.
What I hope to have shown, however, is first that the self-disorder theory should be able to
account for the intersubjectivity disturbances, because these do play an important role in the
suffering of patients and their environment, and in the phenomenological attempt to understand
the disorder. I ultimately agree with Stanghellini that the analyses of the phenomenal (or
minimal) self in early schizophrenia “catch only one dimension of schizophrenic vulnerability
(i.e. the dimension of the personal self), disregarding the fact that the self is not a purely personal
but, rather, a social phenomenon” (Stanghellini 2001, 214). The question then becomes how the
self-disorder should be related to intersubjectivity disturbances, as accounted by the phenomena
described above. It will be necessary, not only to prove the relevance of intersubjectivity in
schizophrenia, but furthermore to re-evaluate the self-concept used in the self-disorder theory.

1.4 Purpose and method

1.4.1 Research Questions

The purpose of this dissertation is to study intersubjectivity in schizophrenia and to answer
two main research questions. The first question is: Is schizophrenia an intersubjectivity-
disorder? This question implies that schizophrenia is more than a self-disorder only, at variance
with what phenomenological psychopathology has claimed so far. Furthermore, it indirectly also
questions the relation between the self-disorder and disturbances of intersubjectivity. Therefore,
the second research question is: Which self-concept is suited to define schizophrenia as a self-
and intersubjectivity-disorder?
The first question will be addressed specifically in Chapter 3, where I will analyse the
intersubjective dimensions of schizophrenia. In order to do so, I will first have to clarify what I
mean exactly by intersubjectivity. This will be discussed in Chapter 2.
The second question challenges in particular the idea that the phenomenological theory of
the self-disorder suffices for a complete account on schizophrenia. In fact, I ask what kind of self

44
is disordered in schizophrenia. I will investigate whether there is a more adequate concept of the
self suited to fit both the subjective and intersubjective aspects of schizophrenia. The answer to
this question will be implicitly present throughout the third chapter, but I will only answer it
explicitly in Chapter 4.

1.4.2 Method
In order to answer the two principal research questions, the text is divided in chapters which
are thematically and methodologically distinct. As the reader already knows, Chapter 1 explains
the philosophical background of the self-disorder in schizophrenia. I have briefly elucidated
three classic positions on the self and the contemporary idea of the minimal and the extended
self. It has been explained that the phenomenological theory on schizophrenia indicates that it is
the minimal self which is primarily disturbed. The discussion then turned towards
intersubjectivity, and summarized the results stemming from developmental psychology to
illustrate another approach to the questions of the self. Lastly, it has been pointed out that within
contemporary psychopathology, intersubjectivity only gets marginal attention, and disturbances
of intersubjectivity are mostly considered secondary. However, I am concerned in this text with
those small indications that intersubjectivity does play a significant role in the phenomenology of
schizophrenia. The early hypothesis I formulate, which will inform the whole text, is that
intersubjectivity plays an important role and that schizophrenia is both a self- and an
intersubjectivity disorder. If my hypothesis proves to be correct, this means that the
phenomenology of schizophrenia may need a different concept.
In Chapter 2 I will offer an account of intersubjectivity, which I believe suited for the study
of its disturbance in schizophrenia. I make reference to the phenomenological ideas of Husserl,
Heidegger, Merleau-Ponty, Waldenfels, and others to clarify the dimensions of intersubjectivity.
I finally distinguish between two kinds of intersubjectivity. First, I discuss ‘Encounters – the
other, and others as constituted’. This is the dimension of intersubjectivity involving direct
encounters with others. It relates to ‘mundane intersubjectivity’, despite this description being, as
it will be argued, somehow inadequate. In this first part of the philosophical investigation of
intersubjectivity, I discuss the following topics: empathy; the distinction between self and other;
the risk of solipsism; and the role of sociality for personhood. In the second part of Chapter 2 I
discuss ‘The shared world – I, the other, and the others as co-constituting’. There, I deal with a
particular kind of transcendental intersubjectivity, namely the question of how subjects co-
constitute their experiences of the world. This section focuses not on the dyadic relationship of
self and others, but on the triadic relationship of self and other towards the world. In this section

45
I discuss the following topics: intersubjective reality in phenomenology; intersubjective
perception; the objectivity of the world; normality; subjectivity in an intersubjective world; and
the problems of transcendental intersubjectivity. Chapter 2 is thus meant to provide the
philosophical tools to examine intersubjectivity in the psychopathology of schizophrenia.
After having analysed the exact meaning of intersubjectivity, I will have to answer the
main research question: Is schizophrenia an intersubjectivity-disorder? Chapter 3 is then a
phenomenological and psychopathological investigation to answer this question. For reasons of
clarity, I divide the chapter in two sections. In the first, I offer a conceptual analysis of key works
on schizophrenia. The self-disorder model strongly relies on the accounts of the classic and
phenomenological authors. I thus examine in this first part of Chapter 3 whether these accounts
on schizophrenia already indicate disturbances of intersubjectivity, and if so, what kind of
disturbances exactly. I therefore discuss the work of three classic authors: Kraepelin, Bleuler,
and Jaspers; three phenomenological authors: Minkowski, Kimura, and Blankenburg; and the
Theory of Mind-account on schizophrenia as developed by Frith.
In the second part of this chapter I will turn to the clinical manifestations of schizophrenia,
and use the conceptual insights of the first part to elucidate different phenomena, symptoms, and
signs from the perspective of intersubjectivity. These might appear very diverse, and a decision
was made to structure them according to the same distinction introduced in Chapter 2. The first
category will cover those phenomena, symptoms, and signs that involve encounters and
immediate contact between persons. This corresponds mostly to mundane intersubjectivity. In
the second category I focus on delusions and on the disturbance of co-constituting reality. This
corresponds mostly to transcendental intersubjectivity. The concepts and ideas of Chapter 2 are
then employed as tools for the newly formulated phenomenology of the intersubjective
dimension of schizophrenia. Chapter 3 should thus allow full assessment of the hypothesis that
schizophrenia is an intersubjectivity-disorder.
Chapter 4 will finally discuss the material to answer the second principal research
question: Which self-concept is suited to define schizophrenia as a self- and intersubjectivity-
disorder? I therefore compare my conclusion from Chapter 3, on the intersubjective dimensions
of schizophrenia, with the self-disorder model. This comparison will allow me to claim that a
different concept is necessary, in order to integrate intersubjectivity. A question that will come
up at this point is why intersubjectivity has been relatively neglected, and I will explain that the
self-model underlying the current self-disorder hypothesis may be the reason for this. I
concretely question how the disturbance of intersubjectivity could relate to the self-disorder
model. One possibility is that the self-disorder is foundational for the intersubjectivity disorder.

46
This is, however, not the view I will defend in this chapter. I argue that the intersubjectivity
disturbances are an essential component of schizophrenia, and I offer a theoretical framework to
integrate these disturbances with the self-disorder. This leads me to redefine, although discretely,
the phenomenological psychopathology of schizophrenia by shifting it from subjectivity to
intersubjectivity. I introduce the term ‘open subjectivity’ to describe both the essential alterations
in schizophrenia and the ‘normal’ relation between self and others. Open subjectivity will prove
to be a concept capable of coherently integrating both the subjective and the intersubjective
disturbances of schizophrenia.
Chapter 5 is the conclusion to this dissertation. I offer a synopsis of each chapter and
indicate the relevance of this research for the philosophy of the self, for psychopathology, and
for psychiatric praxis.

47
 CHAPTER 2: THE PHENOMENOLOGY OF
INTERSUBJECTIVITY
Introduction
How do I experience others and how do others experience me? Can I understand the
others? Are they transparent to me? And can I guess their intentions, their motives, and feelings?
Are we instead completely inaccessible to each other? How do I make myself understood? These
are not just philosophical questions, but also concerns affecting schizophrenic persons in their
interaction with others. 33 These issues may seem irrelevant in our daily involvements, as we
naturally incorporate our answers. However, this may not be the case for patients. Some of these
questions might indeed impede common social interactions. Patients may experience them as
frightening uncertainties, leading to social withdrawal. If one is to understand the intersubjective
dimension of schizophrenia then, these questions need to be formulated and answered explicitly.
In this regard, the phenomenology of intersubjectivity is assumed to be most fruitful. I will
therefore outline a few crucial points in the phenomenological debate on intersubjectivity.
Although the primary goal is not to elucidate the debate in its entirety and in detail, an overview
will help understanding the range and different dimensions of intersubjectivity. As already
anticipated, I decided to discuss intersubjectivity along the lines of Edmund Husserl’s thought.
Although its most explicit discussion can be found in the 5th paragraph of his Cartesian
Meditations, his manuscripts prove that he was already concerned by the issues of
intersubjectivity many years earlier. The vast amount of texts devoted to the clarification of
intersubjectivity was conveniently published in three volumes of the Husserliana series (XIII-
XV). Along with the Cartesian Meditations, I primarily refer to these three volumes to elucidate
Husserl’s ideas on intersubjectivity. His ideas were then further elaborated, commentated and
criticized by, among others, Heidegger, Merleau-Ponty, Schütz, Levinas, Waldenfels, and
Zahavi. I will make reference to their respective arguments to expand Husserl’s original ideas on
intersubjectivity. Upon completion of this chapter, these ideas will offer the philosophical tools
to approach the matter of intersubjectivity in the psychopathology of schizophrenia.
Before venturing into the content of the debate, it is useful to briefly consider the
phenomenological methodology with regards to intersubjectivity. As is well known, Husserl is

33
Chapter 3 will elucidate the exact nature of these difficulties. One of the most famous case studies where
patients asked these very questions concerns Blankenburg’s patient, Anna R.

48
confronted with the issue of intersubjectivity within the framework of his phenomenological
method itself. The question namely arises how other subjects can appear in the experience of a
subject (Bernet et al. 1996, 144; Marbach 2013). First of all, this entails to be able to provide a
suitable account of the subject’s ability to distinguish its own experiences from those of others.
Secondly, it has to be clarified how a subject can experience another subject as an experiencing
subject. Husserl would explain that others have a double presence in the world: they are
‘psychophysical’ objects in the world on the one hand, and subjects experiencing a world – more
precisely – experiencing the same world as I am, on the other hand (Husserl 2012, 91).
On the whole, Husserl aims to reconcile the intersubjective dimension of human
experience with its supposed subjective foundation, which he primarily studies through the
phenomenological method (Duranti 2010, 10). Some of his successors, including Jean-Paul
Sartre and Alfred Schütz, would later claim that he did not succeed in this. They argue that
Husserl’s attempt remains rooted in the phenomenological starting point of the ego. Others, like
Zahavi (1996), on the contrary argue that Husserl makes a genuine attempt to expand the
phenomenological project towards the social-transcendental sphere. Undoubtedly, the challenges
of intersubjectivity, such as the appearance of others and the demarcation between my
experiences and theirs, lead Husserl to reconsider the foundations of his methodology, in order to
account for this new problem of intersubjectivity. From a methodological point of view, in order
to remain within phenomenology, one would have to study the presence of others within one’s
own conscious experience. A phenomenological analysis of intersubjectivity is thus a study of
intersubjectivity-as-experienced-by-a-subject.
In order to study intersubjectivity phenomenologically, Husserl introduces one further
reduction, besides the phenomenological reduction which ‘brackets’ the natural attitude and
opens up a world of phenomena as given to us. One of the main issues concerning
intersubjectivity is clearly how to reconcile the idea of the world as there-for-everyone and the
idea that every sense is internally constituted within the life of a conscious ego (Schnell 2010,
11). Furthermore, intersubjectivity, despite transcending the subject, is only accessible as-
experienced-by-the-subject. “To phrase it differently: transcendental intersubjectivity can only
be disclosed through a radical explication of the ego’s structures of experience. This does not
only indicate the intersubjective structure of the ego, but also the egological attachment of
intersubjectivity” (Zahavi 1996, 6). As it will be made clear further on, the discussion of the
limits of Husserl’s method and project for the study of intersubjectivity leads to strong
accusations of solipsism, as possibly inherent to phenomenology. It is also true, however, that
the phenomenological reduction, and particularly the second intersubjective reduction, indirectly

49
shows precisely the importance of intersubjectivity (Zahavi 2009, 116). 34 But what is this
‘second reduction’? The second reduction is performed within the transcendental sphere, which
is the result of the first phenomenological reduction. Everything that is not related to me, that is
alien, is abstracted. What is left is proper to me (Eigen) or ‘primordial’. The transcendental field
is thus divided into what is alien or what is not-me, and what is mine (Schütz 1966, 58).
However, it might not be as easy as Husserl thought to abstract what is alien and intersubjective
from the essentially subjective. Schütz, for example, argues that whether this second epoché is
actually possible remains a fundamental problem for the phenomenology of intersubjectivity
(Schütz 1966, 67).35
Now that the specific intersubjective reduction introduced by Husserl into his methodology
has been generally introduced, it is time to shift focus from methodological issues towards the
content of the debate. One of the main issues concerns the priority of subjectivity or
intersubjectivity. Is intersubjectivity a construction of the ego, or is the ego constituted out of
intersubjectivity? How are subjectivity and intersubjectivity related? Husserl’s introduction of
the second reduction already implies the idea that on the most fundamental level, the ego
constitutes the experience of the world. The residual sphere resulting from the second reduction
has to be taken as some core foundation, as we cannot experience the alien (das Fremde) or the
objective world without experiencing the primordial proper sphere, and it would not be true the
other way around (Husserl 2012, 95). According to this view, there is a more fundamental layer
of experience, namely the reduced sphere of the ego, where no intersubjectivity is present. Later
on, Husserl nuanced this position. He wrote that the fundamental sphere should not be
understood as solipsistic, as one can experience others within this sphere. This position does not
deny the reality of other people, as it rather concerns the transcendental constitution of
experience. Nevertheless, as it will be argued further below, his investigation of empathy was
also based on the core concept of a subject secondarily confronted with others (Bernet et al.
1996, 148).
Some authors consider intersubjectivity as an additional sphere of experience in the world,
constituted by communication and particularly by language (Duranti 2010, 9-10; Bickerton
2005). In this view, intersubjectivity is restricted to a society or a community, and it is thus the
result of a construction by subjects. Contrary to what has been claimed earlier, and in agreement

34
It namely highlights the ‘natural’ connection to others on the one hand, and the presence of otherness and
intersubjectivity within the transcendental sphere on the other hand. However, this is only an indirect indication
concerning intersubjectivity’s role in subjective life.
35
See (Staehler 2008), for an examination of these reductions and for the role they play in Husserl’s attempt to
answer the question on how the other is given on the most basic level of experience.

50
with Zahavi, I will offer arguments in favour of the idea that Husserl does not restrict his ideas to
the foundational power of the transcendental ego. It will be argued that he did try to analyse
intersubjectivity while avoiding to make reference to the transcendental ego as a priori. 36 For
instance, one controversial attempt to deal with the ambiguities of his ideas on intersubjectivity
is the famous ‘monadology’. With this metaphor of monads, Husserl tries to describe a system of
individual subjects that are somehow related to each other, namely through their ‘windows’.
Thus, he expresses his concern, shared by Zahavi, that every theory of intersubjectivity should
acknowledge a certain degree of ontological independency of the subject vis-à-vis the
intersubjective sphere (Zahavi 2009, 130). Intersubjectivity plays a crucial role in the
transcendental constitution, however it admittedly does so within an a priori subjectivity, which
is responsible for the development and deployment of all the spheres of intersubjectivity (Zahavi
2009, 146; Husserl 1973c, 426). The circularity of this idea shall become clear in this chapter.
In this introductory outline of the issues concerning intersubjectivity, the reader has
already come across some of the main critical issues, such as empathy, solipsism, properness,
and otherness. In order to discuss all relevant topics, I have divided this chapter into two
thematic sections. The first section is called ‘Encounters – The other, and others as constituted’.
Here I discuss what Husserl called mundane intersubjectivity. 37 The purpose of this section is to
deal with phenomenological views on how others are experienced in the concrete ‘natural’
world. It shall become clear what does it mean that others are – in phenomenological terms –
already ‘constituted’ in the experience of the subject. This section includes the following topics:
empathy; the distinction between self and other; the risk of solipsism; and the role of sociality for
personhood. The title of the section hints to the fact that all these topics are related to the direct
experience of real existing people in the world and they are all related to a direct contact through
encounters. Another term for this kind of intersubjectivity would be ‘dyadic’, as this kind of
intersubjectivity consists of encounters with others and the focus is on the encounters
themselves. Some of the most pertinent symptoms, signs, and phenomena of schizophrenia relate
to this kind of intersubjectivity. Typical examples are, for instance, schizophrenic autism and

36
It should be kept in mind that ‘constitution’ in phenomenology does not mean ‘creation’. When Husserl writes
that the world and the other are constituted, this means that they are constituted in the experience of the subject,
which does not equal being produced or being created as such (Zahavi 2009, 120).
37
I chose not to use ‘mundane intersubjectivity’ and ‘transcendental intersubjectivity’ as the titles of these
subsections for different reasons. Firstly, the first section concerns encounters with the other as constituted.
Although mundane intersubjectivity certainly plays a role here, this does not entail that transcendental
intersubjectivity is excluded in our experience of others. In the second section I discuss our experience of the
world with others as co-constituting. This means that I focus on how intersubjectivity influences our
transcendental constitution of the world. This, again, does not mean that mundane intersubjectivity would be
excluded. It will be clear in Chapter 3 that the same structure can help clarifying the disturbances of
intersubjectivity in schizophrenia.

51
social withdrawal. Furthermore, also the alleged incomprehensibility of schizophrenic patients
can be explained within this context. And the famous praecox-feeling can be understood, as it
will be argued in detail, as a disturbance of affective and embodied attunement or
‘intercorporeality’.
The second section is called ‘The shared world – I, the other, and the others as co-
constituting’. In this section I deal with a particular kind of transcendental intersubjectivity,
namely with the question of how subjects co-constitute their experiences of the world. This
section focuses not on the dyadic relationship of self and others, but on the triadic relationship of
self and other towards the world. In this section I discuss the following topics: intersubjective
reality in phenomenology; intersubjective perception; the objectivity of the world; normality;
subjectivity in an intersubjective world; and the problems of transcendental intersubjectivity.
Disturbances of this form of intersubjectivity are most conspicuous in delusions and in
fragmented and derealised perceptions. The absolute certainty of delusions expresses indeed a
disconnection with others and their regulating influence on our experiences. The content of these
delusions often includes feelings of persecution, threatening alterity, and disturbances of self-
other demarcations. The disturbance of flexible perspectivity furthermore emphasizes the
intersubjective nature of the schizophrenic alteration. In order to understand what all these
symptoms, signs, and phenomena are, beyond superficial operational categories, this chapter will
thoroughly investigate the meaning of intersubjectivity. I will claim that intersubjectivity implies
a particular reciprocity or circularity between mundane and transcendental intersubjectivity,
namely how the encounters in the world constitute our subjective or transcendental experience of
the world with others, and how this transcendental intersubjectivity in turn influences how we
interact and encounter others. At the end of this chapter, it will become clear that
intersubjectivity within schizophrenic delusion qualifies as a subjectified intersubjectivity,
whereas the intersubjectivity of the real world is an objectified intersubjectivity.

2.1 Encounters – The other, and others as constituted

2.1.1 Empathy – on experiencing others

I experience the other through empathy (Einfühlung). This might sound trivial,
nevertheless it is the core of Husserl’s ideas on intersubjectivity. Husserl does not use the term
‘empathy’ to describe our ability to have sympathy or to experience what someone else is
experiencing emotionally. Empathy is used in a broader epistemic context and it transcends the
interaction between two people, for example by contributing to our experiences of reality, as it

52
will be explained later on. Before discussing this matter in the second section of this chapter, it is
useful to examine what empathy exactly is.
Empathy is a way of experiencing another subject. According to Husserl, I perceive
another subject not directly, but through a process that starts with the perception of an object and
ends with the understanding of a subject. I perceive the other through his body (Körper). “The
alien body is not “bodily present” as “Leib”, but only as a thing, and his embodiment is only
analogically appresented” (Husserl 1973a, 234). This quote includes all the crucial elements that
shape Husserl’s theory of empathy. First of all, the other is given as a “Körper”, as an object-
body, and not directly as a subject-body (Leib). Only my own body is experienced directly as
“Leib” and therefore “leibhaft” or originally given. The ‘mineness’ of my body is rooted in the
manner of appearance, which distinguishes it from other bodies. Not only my body is originally
given, but also my psychic life: my sensations, my desires and pains, my movements, my
perceptions… “These are perceived (wahrgenommen), which means that they are given as
‘impressions’ in full original presentation, and not by presentification (reproduction)
(Vergegenwärtigung)” (Husserl 1973a, 25).38
It is through analogy that I recognise the object over there to be a body, similar to mine,
and consequently as a subject-body. I do not experience the other as I experience myself, and
therefore empathy occurs indirectly, Husserl argues early on (Husserl 1973a, 221). In fact, I
succeed in experiencing the other as a subject, even without experiencing their experiences.
Indeed, I could only ‘presentify’ (vergegenwärtigen) their experiences, similarly to when I
remember my past experiences. However, these past experiences are mine, because I
experienced them originally at a certain moment in time and they are continuously connected to
my present experiences (Husserl 1973a, 226, 374). I cannot experience the past experiences of
somebody else; for this would mean that two streams of consciousness were actually one and the
same. Therefore, the experience I have of the alien other is not the experience of his experience
(Husserl 1973a, 221; 2012, 108).
Husserl concludes that a different kind of presentification, other than memory, must be at
work here. He then introduces the term ‘appresentation’ (or compresentation) (Husserl 1973a,

38
‘Vergenwärtigung’ or ‘presentification’ is a concept Husserl developed within his theories of perception and
imagination, and as it will be argued shortly, it plays an important role in experiencing others. Presentations or
impressions are the lived experiences of what is originally given, in propria persona, or in-the-flesh (leibhaft).
Presentifications are experiences of what is not originally given, such as in phantasy, memory, or expectation.
‘Vergegenwärtigen’ is sometimes translated differently: to presentify, to reproduce, to represent, and to re-
presentificate (Bernet et al. 1996; Moran and Cohen 2012). Presentation and presentification are not always
clearly distinct elements of our experience, and they may transform into one another or at least influence each
other. A perception of an object with affective meaning might bring about a particular memory, for example
(Breyer 2011, 161).

53
28). Similar to when I perceive an object in a room, and I appresent parts of the object which are
not given to me directly in perception, so too does a special kind of appresentation present me
with indirect, unperceived elements of the body I perceive. Just as I would appresent the back of
a chair when I only see the front side of it, so too do I appresent the inner life and subjective
experience of the other based on the perception of his body (Husserl 1973a, 224; 1973b, 65).39
Husserl does not imply that my assumptions on the subjective life of the other are always
correct. The appresentation is namely a never ending process, it remains undetermined and open
(Husserl 1973a, 225). It can therefore never be ‘correct’, the reason being that the other remains
other. “In the appresentation of the other the synthetic systems might be the same, with all the
correlating ways of appearance, thus with all possible perceptions and their noematic contents;
but the concrete perceptions and the realized presentations, and partly also the real perceived
objects themselves are different, as these are the objects which are perceived from there”
(Husserl 2012, 123 - emphasis added). The other has a different position and a correlating
different perspective, which makes their experiences different. I am unable to completely take
the position of the other, to perceive what they perceive and to experience what they experience,
in short, to take on their system of orientation, because I am bound to my own perceptions and
experiences through my own body (Husserl 1973a, 412).40 The openness and incompleteness of
empathy is not only a consequence of one’s incapacity to fully fulfil empty intentions, which
characterize apperception and appresentation. It is rather restricted to the conditions of one’s
own embodiment.
Later on Husserl claims that the other body is recognised to be a ‘Leib’ (Husserl 1973b,
65). “The “other” as constituted refers to me, the other is a mirroring of my self, and yet he is
not; he is an analogy of my self, and yet again he is not an analogy in the usual sense” (Husserl
2012, 94). The mirroring happens as I project my primordial experiences of the mineness of my
experiential life onto the body I perceive (Husserl 2012, 148). Now, the question is what kind of
motivation is required for the mirroring of my inner conscious experiences to be triggered? The
body of the other needs to be distinct from inanimate objects. It has to manifest something vital
through verbal and behavioural expressions. There has to be a similarity (Ähnlichkeit) between
my body and the body I perceive in order for me to experience it through empathy as another
39
Pace Husserl’s argument that the appresentation of another’s subjective life is similar to the apperception of an
object that I only perceive partly, there is at least one important difference. Apperception is an associative
element of the passive synthesis of experience (Husserl 2001a, 164). It functions on a different level than
appresentation, which requires a more active attitude of the subject towards others. However, as Husserl’s ideas
on empathy shifts from a two-step or indirect process towards a more direct process, this distinction would only
matter in a constitutional analysis.
40
In the following subsection the importance of this point will be made clear while discussing the otherness of
the other.

54
subject (Husserl 2012, 110; 1973b, 9). Husserl calls this recognition of similarity ‘pairing’
(Paarung) (Husserl 2012, 119). Pairing is a process of association, on the lowest levels of
experience, and does not require active or reflective reasoning (Bernet et al. 1996, 149). We
immediately experience that body over there with its movements and gestures as an embodied
subject and appresent its subjective experience.
Several phenomenologists have discussed whether empathy is a direct or indirect process,
and what exactly Husserl’s position on this point is (e.g. Schütz 1942; Yamaguchi 1982) 41 .
Arguments for both views can be found in his work. In opposition to the idea of analogy based
on similarity, he writes, for example, that there is no real analogy in the first place, nor can we
really talk about empathy (Einfühlung): “There is no real empathy, as I once said. And there is
no analogy, no conclusion based on analogy, nor transference through analogy” (Husserl 1973a,
313, 338). The analogy is hence not required in order to apperceive. In contemporary terms, and
with reference to the third chapter, the same idea could be rephrased by saying that there is no
need for a ‘theory of mind’ (Premack and Woodruff 1978) or a proper representation, in order to
understand the other as a subject (Husserl 1973a, 339). Husserl would then conclude that
empathy is an immediate grasp of a non-present presentation, motivated by an external
perception (Husserl 1973a, 311).
Alfred Schütz has written one of the most noteworthy critiques of Husserl’s ideas on
intersubjectivity, and particularly on empathy. In his article ‘The Problem of Transcendental
Intersubjectivity in Husserl’ (1966) he argues against what he believes are the weak points of the
phenomenology of intersubjectivity.42 It is then worth briefly looking at some of the main points
of controversy he identifies concerning empathy. First of all, Schütz argues that pairing cannot
be the mechanism behind the recognition of the object-body as a subject. Pairing admittedly
requires a passive recognition or association of the typicalities of the object I perceive with the
typicalities of my own body as I perceive it. However, we do not perceive our own body the way
we perceive a body-over-there: “The other body is visually perceived, but my body is not, as a
rule, visually perceived by me, and even if it is, then only partially. My living body is, to be sure,
always present and given as the primal instituting organ. But it is present as an inner perception
of its boundaries and through the kinaesthetic experience of its functioning” (Schütz 1966, 63).

41
Yamaguchi (1982, 87) explains the importance of Husserl’s study of passive synthesis within his view on
empathy. This made Husserl realise that we understand others passively and directly, without the need for an
active analogy or inference. Yamaguchi himself consequently proposes that the passive synthesis is inherently
intersubjective and rather than being fundamental for active experience it is interwoven in reciprocity
(Yamaguchi 1982, 121, 143).
42
It has to be noted that Schütz based his critique mostly on the Cartesian Meditations, and he did not refer to
the three volumes on intersubjectivity (Schütz 1966, 78).

55
Any claim concerning pairing as the basis for the passive recognition of analogy and similarity
would therefore neglect the originality of my experience of my own body, opposed to the objects
and bodies I can perceive in the world. “It [my body] is thus present precisely in a way which is
as dissimilar as possible from the external perception of an animate body other than mine and
therefore can never lead to an analogical apperception” (Schütz 1966, 63).
The second point of disagreement concerns the concept of appresentation, as based on
apperception. Is appresentation the right concept to describe how I understand that the object
over there is the body of another subject? Do I appresent the subjective life of the other based on
the perception of his body? First of all, Schütz questions the value of the presence of the body.
“It must also be asked whether in fact the bodily appearance of the Other in my primordial
sphere has the decisive significance which Husserl ascribes to it. I empathize much more with a
philosopher spatially and temporally distant than with my neighbour in the subway who is given
to me in person (leibhaftig) but as a stranger (Fremder)” (Schütz 1966, 81). Secondly, and more
decisively, the question is whether our understanding of another being is really based on a
mechanism like apperception. As earlier discussed, Husserl understands apperception as the
possibility to grasp an object in its totality, despite the fact that a perceiver only perceives one
side or aspect of the object. Similarly, I grasp the complete chair, even though I only perceive the
front side. Arguably, I am able to do so because of the possibility to walk towards the chair, walk
around it, and perceive it from all sides. Apperception is then a way of anticipating the possible
originality of what I do not perceive originally – e.g. the back of the chair. Husserl thus claims
that the appresentation of the subjective life of another person works similarly to apperception
(Husserl 1973b, 244; 1973a, 65).
In a letter exchange reacting to Schütz’s article, Eugen Fink (in Schütz 1966, 85) wrote:
“… appresentation has the character of redeemableness (Einlösbarkeit). I now ask: is the
appresentation, in which the Other is given, also determined by this fundamental sense of
redeemableness or is it an appresentation which essentially cannot be redeemed?” The answer is
of course negative. The other exists for me and is apprehended by me as having certain
determinations, but he is absolutely inaccessible to me in his original being (Schütz 1966, 54).
Were this not the case, then the other would not be other, but we would share the same original
experience and the same stream of consciousness, thereby annihilating our difference.
Husserl himself already anticipates this inaccuracy. He writes in an addendum from 1921
that the subjective life of the other, which is ‘emptily intended’, is continuously filled by the
other’s (verbal or non-verbal) expressions. There is no way of fulfilling the ‘empty intentions’
(Leerintentionen) with original impressions, as in the example of the perception of the backside

56
of the chair. In fact, a continuous but incomplete fulfilment takes place (Husserl 1973a, 225).
Therefore, the other confirms the empty intentions I have, based on his behaviour and
expressions. “… this perception is “incomplete”, always open, in so far as the human being over
there, and especially his inner life is only partially expressed in reality, while the rest remains
undetermined and open, or it refers to previous “perceptions” of already perceived sides, which
are therefore simultaneously “co-perceived” (mitwahrgenommen)” (Husserl 1973a, 225). So not
long after the introduction of his ideas on analogy and appresentation, Husserl acknowledges the
difficulties that Schütz would later review in his article.
One element to be added is that Husserl was mainly interested in how the subject’s
experience of the other was actually possible. Therefore, when he discusses how the subject
apprehends the other’s subjective life and recognises a moving object as a person, his inquiry
should be taken essentially as a study into the transcendental conditions of the subject’s
experience. Indeed, such an object of study is different from – say – a house, nevertheless
Husserl’s foremost focus embraces the constitution of the experience itself.
Merleau-Ponty, as it will be discussed in more detail further on, argues that we do not
perceive the other and their expressions the same way we perceive objects in the world. We
immediately understand others, he claims, through our shared intercorporeality. “The sense of
the gestures is not given, but understood, that is, recaptured by an act on the spectator’s part”.
And our communication or comprehension of the gestures of the other is possible only because
of the reciprocity of my intentions and the gestures of others: “It is as if the other person’s
intention inhabited my body and mine his” (Merleau-Ponty 2005, 215).
Similarly, according to Waldenfels, understanding the other in the concrete natural world is
less based on appresentation, and more on sharing a practical engagement with the world. He
argues that the other in the encounter is not primarily the object of our observations, but a co-
subject in a common practical involvement (gemeinsamens Tun) (Waldenfels 1971, 136).
Because of this practical involvement with others, we do not need explicit attempts to understand
the other; we already do so when we are involved in the world.
This view mirrors Heidegger’s ideas on Dasein as being-in-the-world and being-with-
others, as developed mostly in the 26th paragraph of Being and Time43. There, Heidegger clarifies
that we do not use empathy based on appresentation, but we firstly encounter the other in and

43
Heidegger’s Dasein is not equal to Husserl’s ‘ego’, ‘I’, ‘subject’ or ‘selfhood’. Dasein itself was only an
indirect element in Heidegger’s investigation of the question of Being. Whereas Husserl and others were
interested in the subject or the person as such, Heidegger was interested in the being of the subject or the person
(Dallmayr 1980).

57
through the world. Empathy does not constitute our experiences of others, since being-with-
others is what permits empathy in the first place (Heidegger 1967, 125). Again, the being of
others is taken to be different from the being of objects. The other is in the world as Dasein as
well. “These beings are neither present-at-hand (vorhanden), nor ready-at-hand (zuhanden), but
they are like the very Dasein which discloses them – they are there, too, and there with (auch
und mit da)” (Heidegger 1967, 118). Understanding the other is neither a process of inference
nor of empathy for Heidegger. Finally, understanding the other is an essential part of
understanding Dasein itself, as Dasein’s being is being-with. Concretely, this means that the
understanding of others is not a matter of knowledge or recognition, but rather an original way of
being, which is the condition for all forms of knowledge and recognition in the first place:
“Knowing oneself is grounded in the original understanding of being-with-others” (Heidegger
1967, 123). In other words, we are able to understand others, because understanding involves the
acknowledgement of possibility (Möglichsein) (Heidegger 1967, 143). Although this was not
explicitly described in Being and Time, it can be suggested that an understanding based on the
acknowledgement of different possibilities of being can play an important role in psychiatry.
Indeed, psychiatric understanding implies an explicit attempt at evoking the patient’s
experiences within oneself as a possibility of one’s own being, for example based on the
additional experience one gathers in repeated contact with patients. Heidegger also claims that
this kind of understanding is a priori to any other form of knowledge (Heidegger 1967, 149).

Concerning Husserl’s transcendental explanation of how we experience others in the

world, in the light of his transcendental study of empathy, one might claim that he did not go far
enough. Indeed, understanding others is not just an intellectual or cognitive process of a
solipsistic ego, and what he advocates as indirect or inferential understanding of others seems
problematic and certainly too restricted. His successors each expanded these ideas in their own
ways, in an attempt to make explicit what Husserl did not. They investigated whether and how
we are related to others beyond or before the inferential processes involved in understanding. It
has to be said, however, that Husserl’s ideas on understanding others evolve from a mediated to
an immediate process. This development namely concerns pairing and analogy, which he
considers some of the ‘lowest’ forms of passive association, therefore happening immediately.
Whenever the interpretation emphasises the inferential or cognitivistic aspects of his theory on
empathy, it fails to acknowledge that these are transcendental processes rather than intellectual
efforts. Still, Husserl arguably missed out on certain aspects of intersubjectivity, which his
successors have rightly criticised him for. Husserl tends to shift the weight of the

58
phenomenological investigation towards the subject, and thereby minimizes the role of the other.
A recurring argument in this investigation is the demarcation of self and others. It is now time to
examine how the phenomenological method helps distinguishing between my experiences and
those of others.

2.1.2 The other as other

Husserl considers the other as an ‘alter ego’. An alter ego, inasmuch as the other is
different from me. Even if I presentify the experiences of the other, I still do not experience them
myself. Consequently, Husserl compared my relation with an alter ego to a fictionalisation
(Umfiktion) of my ego. All other people are fictionalisations of my own experiential life, but they
all relate to their own system of experience, which are all incompatible with mine (Husserl
1973b, 138). What is it that makes my experience different from the experience of another ego I
perceive? First of all, there can only be one ego experiencing a set of experiences, because if
there were two egos experiencing the same, they would not be different egos. When I am with
someone else, I can be the only one to experience my experiences, otherwise the alter ego would
not be ‘alter’ (Husserl 1973b, 138). But how can I distinguish the other from myself? As
previously explained, I pair similarities between us, I use the sameness of the other to understand
them as subject. But in order to experience them as alter ego, as a subject different from me, I
have to recognise that the body I perceive is not my body.
The solution to this question is simple: there is nothing in the subjective life of the other
that can be realized in my own primordial sphere (Bernet et al. 1996, 150). I am able to
presentify (vergegenwärtigen) the other’s subjective life, and in doing so, by empathy, I transfer
myself to the position of the other. However, this is only partially and only temporarily possible,
as I am unable to remain in the position of the other. 44 I am bound to my own centre of
experience, to the zero-point of my orientation (Husserl 1973a, 265). My body has something
which the other bodies lack, and that is the way my body is given to me in comparison to how
other bodies appear (Husserl 1973a, 275; 1973b, 7).
The zero-orientation of my experience (Nullerscheinung) is essential for my experience of
my body. However, I also have the possibility to rethink or imagine my body as perceived from
somewhere else, “from the outside” or eccentrically (Husserl 1973a, 276). Anyhow, although I
can perceive my body in the mirror, or I can see myself on film, only the zero-orientation of my
body makes it essentially my subject-body (Leib) (Husserl 1973a, 329).

44
With reference to Fuchs (2005a) one could argue that this would only be possible as an ‘as if’. We understand
the others ‘as if’ we were in their position. Simultaneously, we are well aware that we are not.

59
 So, what does belong to me and what to the other? Husserl argues that: “Originally given is
the self, the I and everything belonging to the I, like my body, my fields of sensation, my
movements, my activities, my appearances, etc. The here and now is originally given, the only
original here and now. What is furthermore originally given is my ‘just now’, my continuity, my
temporal horizon, and my past horizon” (Husserl 1973a, 306-307). And later on he adds: “All
possibilities of the kind of ‘I can or could’ have this experience – including: I can foresee and
look back, can penetrate revealingly in the horizon of my temporal being – all this clearly
belongs essentially to my self” (Husserl 2012, 110).
The common element of all this is that it is mine, it is given to me, it has the quality of for-
me-ness. Interestingly, Husserl remarks that this originality is primordial: “Initially I do not
know of any other I or of the possibility thereof” (Husserl 1973a, 307). Only secondarily am I
confronted with an other. And this other must be given entirely differently from how I am given
to myself. The other cannot arise from me, because he would still be part of me. The other
instead transcends my subjectivity. It has been discussed earlier how, according to Husserl, a
subject presentifies the other and his subjective life, including his intentions and experiences.
This entails that my experience of the other is based on empathy and therefore the experiences of
the other are not originally given to me. I experience the other originally, but not his experiences.
I therefore do not grasp the other in his totality. If I were to understand the other in his totality, if
empathy implied experiencing the experiences of the other, then there would be no other. The
incompleteness of empathy is not a failure or a human incapacity, but it is the condition for me to
experience the other as other in the first place.
So what makes the other other than me? Now that it is clear what belongs to the self, it is
also clear what does not. The experiences of the other are inaccessible to me. I cannot experience
them originally. What I presentify are possible experiences, which are not the exact experiences
of the other, and which are only there for me in my stream of consciousness. They are possible
experiences, but at the same time, they are principally impossible (Husserl 1973a, 317). “The
concept of ‘alien subject’ (fremdes Subjekt) entails a new stream of consciousness, in my actual
stream of consciousness, but a presentified and not a present stream” (Husserl 1973a, 317). My
original primordial sphere is separated from the primordial sphere of the other by an abyss
(Husserl 2012, 120).
It will become clear later on that the distinction between me and other plays an important
role for our world-experience. In order to experience the world as real and independent of
myself, I need an experience of otherness. Otherness in this context is called transcendence, as it
involves what transcends my immanent sphere. The other transcends this immanent sphere –

60
even though they first appear in it as given to me. However, as previously argued, the other is
more than just given to me, and what is given is only partial. The otherness of the other provides
a clear grasp of the transcendence, and consequently, of the objectivity of the world.
It is worth remarking that Heidegger, Fink, and Schütz all argued against Husserl’s idea of
the alter ego. They rightly claim that Husserl’s concept of the alter ego is too much of a
reduplication of the ego. And this does not suffice, as there are enough examples proving that the
other is precisely not what I am. Fink suggests to think about an alter ego of a different sex. In
that case, would it be correct to think about the other as having the same functioning subject-
body (Leib), when clearly, the other sex is anatomically different? All differences proper to
someone’s body are counterarguments for the analogy and similarity of self and other. The other
is then required to be truly other than me.
According to Husserl, the otherness or transcendence of the other is not only relevant for
my experience of the world, it is involved in the constitution of the ego as well. “Everyone
identifies himself as the psycho-physical I and distinguishes himself from others, and in the
distinction from others he will identify and recognise himself for the first time as a true unity”
(Husserl 1973a, 244). In the following quote Husserl emphasises once more that the I identifies
itself negatively through the other: “… the I is specified or individualised through the distinction
of I and not-I, by the multiplicity of consciousness as correlation of the multiplicity of bodies”
(Husserl 1973a, 244). Later on he pursues this line of thought even further: the subject only
becomes a subject in the I-Thou interaction (Ich-Du-Beziehung) and in empathy (Husserl 1973b,
170). It has been argued that a logical consequence of this claim is that my ownness or self-
awareness is the result of disowning the other. This means that I only become self-aware through
a process of defining who I am not and what does not belong to me (Oliver 1995). But do we
really need another subject to identify and recognise our own I?
“I find myself as an I-pole, as a centre of affections and actions, I find myself related to a
real surrounding world. Eidetically I understand that ‘I’ as a pole is unthinkable without a real
surrounding. The I is in fact unthinkable without a not-I, to which I can intentionally relate”
(Husserl 1973a, 244). It seems therefore unnecessary to claim that the other in the strict form of
another subject is required for the I. Husserl himself was ambiguous on the matter. In the
Cartesian Meditations he writes “The very first alien (the first “Not-I”) is the other I” (Husserl
2012, 106), while he elsewhere says that the experience of not-I, which is not per se another
subject, suffices for the I to emerge (Husserl 1973a, 30). Nevertheless the particular I-Thou
interaction, and specifically being perceived by the other, clearly adds a layer to my self. For I

61
become aware of being an object in the eyes of others, which is a quality of my self that I cannot
constitute myself (Husserl 1973a, 129).
Expanding on this topic, Sartre famously remarks that the essential step of intersubjectivity
concerns becoming aware of being an object for others (être-vu par autrui), or being-for-others
(Sartre 1943, 296). Experiencing being-for-others as an object of their experience decentralizes
my own experience of the world. This means that I am no longer the sole centre of the world, but
become aware of multiple centres related to multiple others (Rodemeyer 2006, 191). Differently,
according to Heidegger, the others are not defined or encountered as not-I, but firstly as those
who are like me: “‘The others’ does not mean everybody else but me – those from whom the ‘I’
distinguishes itself. They are, rather, those from whom one mostly does not distinguishes
oneself. They are, rather, those among whom one is too” (Heidegger 1967, 118). The others are
not like objects or tools (Zeug) in the world, which are ready-at-hand (zuhanden). Rather, they
are Dasein themselves, and each of them finds itself caring in the world (Heidegger 1967, 121).
This point is in line with Heidegger’s critique of Husserl’s empathy theory and the ‘reduplication
of the ego’ onto the other (Heidegger 1967, 124).
However, throughout this consideration of the role of the other and otherness for the
subject, the very question has been neglected of what kind of I is supposed to emerge through
interaction or through the presence of a not-I. It is clear that through social interaction the I
develops as a person, with habits, personal preferences, manners, and so on (Zahavi 2008, 130).
But does the other or otherness have a role to play on a much more fundamental level, on the
level that Husserl called the primordial original sphere? It has already been explained how the
most fundamental essence of an I is the original self-givenness or the for-me-ness of experience,
as Zahavi has rephrased it. However in the light of Husserl’s line of argument, one might well
still ask: where does the for-me-ness come from, if not from a distinction between me and not-
me? It is crucial to see that claiming the original primordial sphere to be characterized by
exclusion of not-me and by for-me-ness implies that the I-pole of the experience must already
recognise that these experiences are mine and not experiences of others. A distinction between
me and not-me seems then a necessity for any self-awareness, that is, for the fundamental level
of self and experience.45
Interestingly, Husserl quotes Lipps in a short note to a 1910 text: “Consciousness is
essentially not individual, but just consciousness. Only when I know of others, does the I become

45
This does not mean that ‘not-me’ should be understood as ‘the other’, as it equally implies ‘otherness’. The
experience of pain, for example, seems to already imply the simultaneous experience of self and otherness
without first requiring any experiencing of the other. Thanks to Thomas Fuchs for this critical counterexample.

62
this I, one of many, in short: individual” (Lipps quoted in Husserl 1973a, 245, note 1).46 One
may well argue, then, that there is a neglected or even suppressed argument in Husserl’s work on
intersubjectivity. He addresses it shortly, while challenging his own concept of
phenomenological reduction. “One should reduce towards the mere cogitations, towards pure
consciousness; but whose cogitations, whose pure consciousness?” (Husserl 1973a, 155).
In order to further clarify this point, the reader should be reminded of the term
‘abstraction’, already encountered when introducing the second or intersubjective reduction. This
reduction was supposed to outline the primordial sphere within the transcendental sphere.
Husserl describes this in his ‘Fifth Meditation’ as an abstraction (Husserl 1988, 93, 95, 96). It is
furthermore important that the exact meaning of abstraction is made fully clear. In fact, an
abstraction is the distinction of two or more elements that belong together ontologically, and
which are distinguished for the mere purpose of clarification.
The relation between colour and extension offers a good example of abstraction (Husserl
2001b, 7). One can think of either one of them abstractly, but they cannot exist without the other.
Abstractly, I can think of a colour, but it is always related to its extension, and the other way
around. Now, once the importance attributed by Husserl to the term abstraction in his ‘Fifth
Meditation’ is fully acknowledged, also a different and non-solipsistic interpretation can be
formulated concerning his intersubjective reduction. It is clear, indeed, that bracketing, reducing,
or abstracting otherness and intersubjectivity from the transcendental sphere does not imply that
the resulting primordial sphere is actually independent or even foundational of this otherness and
intersubjectivity. If one was to ignore that it is an abstraction, it should be concluded that Husserl
must have started from a solipsistic ego. However, in the light of the concept of abstraction, it is
clear that the own and the other are ontologically related to one another. It is also clear how
Husserl could possibly claim that the I is always dependent on the not-I, as previously explained.
“Just as Husserl never denies that we always already experience the world as objective, so he
also does not deny that our experience is intersubjective from the beginning. Only by way of
abstraction can we sever this link to the Other and then re-establish it” (Staehler 2008, 102).47
As matter of fact, Husserl is more interested in the epistemic relation to the other, than in
this mutual ontological relation between self and other, and we do not find further elaborations

46
The reader might recall that Husserl’s notion of the I or the self is ambiguous, and too complex to be analysed
in detail in this text. However, one could, for example, argue against my interpretation of this quote that the ‘I’ is
used to indicate the person or the individual, and not something like a basic sense of self. Other arguments
against the idea that the experience of the other is a condition to experience the self is found in the previous
chapter on development.
47
Still one may well ask how I am able to distinguish the own from the other in the abstraction, on what basis do
I recognise otherness and ownness within the abstraction of the intersubjective reduction.

63
of these ideas in his work. For Merleau-Ponty, on the contrary, the ontological relation is
essential. He argues indeed for an a priori unity of subject and object, of I and other in an
“intercorporeal being” (Merleau-Ponty 1968, 143). Only secondarily, for example through
reflection, do these entities become distinct and only then does the subject become
individualised. Levinas and Waldenfels, on their turn, emphasise the difference and distinction, –
in short – the otherness of the other (Levinas 1961, 21, 23, 29, 83; Overgaard 2007, 115-116).
According to them, the other is not encountered as an alter ego, for whom I am an object. The
other is firstly the one who surprises me, who appeals to me, who speaks to me, and who is
therefore asymmetrical to me. “The thing cannot relate to me, it cannot answer or contradict
me”. The other, on the contrary, answers, contradicts, and surprises me (Waldenfels 1971, 138).
The other is the one whom I must respond to (Waldenfels 2006, 61).
The otherness of the other is thus not the consequence of a human incapacity to grasp the
other in his totality, but it is the condition for an experience of self or self-awareness, and, as
argued in what follows, for the transcendence and reality of the world as well. Although the
ontological connection with the other is implicitly assumed by Husserl in his use of the
abstraction in the intersubjective reduction, he nevertheless fails to clarify its role for the
experience and constitution of the subject. It is therefore no wonder that he has been accused of
solipsistic tendencies.

2.1.3 Solipsism
Is the I in Husserl’s phenomenology a solipsistic I? From the previous discussion, one
should already conclude that it is not. Indeed, the I needs the other to emerge as itself.
Nevertheless Husserl’s phenomenology has often been criticized for starting from a solipsistic I.
The main argument pointing to a solipsistic dimension in Husserl’s understanding of
intersubjectivity is that, according to it, the subject is incapable of experiencing another subject
directly. As previously explained, according to Husserl, I can only grasp the other through
appresentation: “An S (subject) can only recognise himself and his own experiencing, and were
it to recognise a spatial-temporal world through the use of apperception, this world would be his
and only accessible to him” (Husserl 1973a, 373). Within the framework of an evaluation of
Husserl’s position as solipsistic, one more quote should be investigated: “The ideally firstly
constituted reality is the solipsistic, and it is completely grounded on the solipsistic stream of
consciousness. The intersubjective reality, the objectivity for “every” subject is constituted by
empathy” (Husserl 1973b, 7-8). Husserl does indeed indicate that the primordial sphere is a
solipsistic sphere with its own “reality”. However, it is only when an “alien body enters in

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between the solipsists” that a new kind of transcendence emerges (Husserl 1973b, 8). And
therefore, “we can say that this solipsistic world was still just an “immanent” world. It did not
transcend me at all” (Husserl 1973b, 8). This implies that the priority of the ego should be
understood as limited to the sphere of immanence, whereas Husserl acknowledged that the ego is
constituted by transcendence, or by what it is not: otherness and the other.
Early on in his work, Husserl borrows Leibniz’s term ‘monad’ to describe the original
sphere of the ego. “A monad without windows, without interaction, but with only a universal
harmony” (Husserl 1973a, 7). Merleau-Ponty (2005, 418) remarks that such an idea of
consciousness, compared to the real life situation of encountering meaningful others, leads to
“the absurdity of a multiple solipsism”. However, as Bernet et al. (1996, 146) have explained,
within Husserl’s work, there are two meanings of ‘the primordial sphere’. The first is the
solipsistic sphere, where the ego is an independent moment preceding every experience,
including the experience of the other (Fremderfahrung). Husserl calls this independent moment
the substrate or fundament (Unterschicht) of all experience (Husserl 2012, 96). The second
meaning refers to a dependent moment of every experience – but within those experiences.
Husserl elsewhere nuances the solipsistic tendency of the first meaning of the primordial sphere
(Husserl 1973b, 10). His description of the ‘monad’ includes the original givenness of
experiences, being a centre of functions, and being a body with an absolute here. “Every I is a
“monad”. But a monad with windows. They do not have windows or doors in the sense that
another subject could enter, but rather in the sense that they (the windows are moments of
empathy) allow the other subject to experience similarly to when one remembers past events and
memories” (Husserl 1973a, 260). To be specific, each monad has an endless amount of windows
and these windows stands for possibilities of being influenced from the outside (Husserl 1973b,
295) and having “comprehending perceptions of the other’s body” (Husserl 1973a, 473).
The experience of the other through empathy thus allows for the primordial self – who
might be considered original and singular – to enter the community of monads. “It [the Self] is
one and singular only to the extent to which all the other Selves are too” (Schnell 2010, 18). That
is the true meaning of the multiplicity of the monads: from singularity to community of
singulars. And, importantly, this is not unidirectional. Intersubjectivity adds sense to the original
experience of the subject and “to the unique world of everyone” (Schnell 2010, 18-19).
Furthermore, based on the discussion of Husserl’s theory of perception in the following section
of this chapter, one will also discover that intersubjectivity might play a role even before the
encounter with others. Indeed, similarly to Heidegger’s later remarks in Being and Time
(Heidegger 1967, 114), Husserl already indirectly acknowledges the presence of other subjects in

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every kind of perception in the unique world of everyone.48
In his critical analysis of Husserl’s ideas on intersubjectivity, Schütz finally recapitulates
what Husserl seems to neglect: “It is to be surmised that intersubjectivity is not a problem of
constitution which can be solved within the transcendental sphere, but is rather a datum
(Gegebenheit) of the life-world. It is the fundamental ontological category of human existence in
the world and therefore of all philosophical anthropology. As long as man is born of woman,
intersubjectivity and the we-relationship will be the foundation for all other categories of human
existence” (Schütz 1966, 82). He then goes as far as to claim that even what Husserl would
definitely count as part of the original or primordial ego sphere is just the consequence of
mundane intersubjectivity: “The possibility of reflection on the self, discovering of the ego, the
capacity for performing any epoché, and the possibility of all communication and of establishing
a communicative surrounding world as well, are founded on the primal experience of the we-
relationship” (Schütz 1966, 82). Therefore, what Husserl does, in the eyes of Schütz, is to
neglect the hidden intentionality of the founding mundane intersubjectivity, and he does so “by
elimination, by means of the reduction, of the essential content of the world accepted by me as a
world for everyone” (Schütz 1966, 83). It is after all the biggest weakness and the biggest danger
of solipsism, to only emphasise the transcendental and lose the mundane out of sight.
Conversely, Heidegger does not neglect the mundane, as Dasein is essentially in-the-world.
The question of how we understand others and how we experience others to be real are both
based on a more fundamental certainty or trust which emerges from everyday life in-the-world.
“The clarification of Being-in-the-world showed us, that a mere subject without a world does not
exist or is not given. And likewise an isolated I is not given without others” (Heidegger 1967,
116). The claim that Dasein is being-with (Mitsein) is not just a factual or ontic description of the
impossibility to be alone in the world, but it carries an existential-ontological meaning
(Heidegger 1967, 120). 49 Waldenfels’ later dialogical phenomenology, inspired by Merleau-
Ponty and Levinas, equally takes position against solipsism. Humans can only purposely
establish a dialogue with other humans, by turning the other into an object (Waldenfels 1971, XI,

48
The tendency towards solipsism, or the tendency to interpret Husserl in this way, is certainly related to the
phenomenological method in general. Husserl’s primary goal concerning intersubjectivity was to investigate how
the presence of the other is given to me. He therefore analysed the experience of the other (Fremderfahrung)
within his own primordial sphere. This primordial sphere is not per se solipsistic, as it involves the experiences
the ego has of others. Therefore, it does not bracket others as such, but only the noematic correlates the ego has
of the others in his primordial sphere (Bernet et al. 1996, 146).
49
In Being and Time, Heidegger insufficiently specifies the ‘Mitsein’ or coexistence that links individuals.
Being-with includes encountering others indirectly through the world. But other forms of Being-with, including
the interpersonal encounters themselves, seem to be underrepresented in this work. See Schatzki (2007) and
Oliver (1995).

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368). We are therefore always already in dialogue with others, and these others are undeniably
there. Even before we turn towards the other in a dialogue, we are already there for the other, just
as the world, inhabited by others, is already there for us. As already remarked before, the reader
should keep in mind that Husserl was primarily interested in the transcendental conditions of our
experience. In this context, the question thus becomes how others appear to us. He does not
doubt that others appear to us, and therefore, that others are there. But, as Oliver (1995, 108)
noted and, as it can be concluded from the previous subsections on empathy and otherness of the
other, Husserl tends indeed to shift the focus towards the subject, and thereby minimizes the role
of the other.
One further element counterbalancing solipsistic tendencies in phenomenology is found in
embodiment. ‘Embodiment’ is basically the term to designate that consciousness is not a
transcendental free-floating and transparent spirit in the world. Embodiment emphasises that
consciousness is necessarily bound to a body, and our encounters with others happen under the
form of embodied encounters. The term ‘intercorporeality’ was first introduced into the debate
by Merleau-Ponty. In the section called ‘The Philosopher and His Shadow’ in Signs, he describes
how shaking hands with another being makes that other being animate, similarly to when my one
hand touches my other hand. Without introjection, analogy or comparison, my body “annexes
the body of another person”. Just like my two hands are part of the same body, when I touch my
left hand with my right, so too do I and the other become “the organs of one sole
intercorporeality” (Merleau-Ponty 1960, 167). In the Visible and the Invisible, he clarifies the
synergy between two eyes, two hands, to sense the sensed. These sensing parts are one and offer
one experience because they essentially belong to one body. The unity of my experiences is
therefore not the result of a synthetic activity, but rather of the unity of my body.
Consequentially, Merleau-Ponty asks: “Why would not the synergy exist among different
organisms, if it is possible within each? Their landscapes interweave, their actions and their
passions fit together exactly: this is possible as soon as we no longer make belongingness to one
same “consciousness” the primordial definition of sensibility, and as soon as we rather
understand it as the return of the visible upon itself, a carnal adherence of the sentient to the
sensed and of the sensed to the sentient” (Merleau-Ponty 1968, 141).
The counterargument against solipsism, as found in Merleau-Ponty’s work, is a carnal,
fleshy intercorporeal being, which allows the transitions from one body to the other. The
problem of the alter ego disappears, as egos are merely by-products of fleshy relationships. “The
thickness of the flesh guarantees relations, while the skin insures that we can distinguish our
experience from the other’s. Yet, since the flesh and skin are not objects, but synergic, we are

67
never cut off from the other. The skin is a boundary, but a permeable boundary” (Oliver 1995,
99). Intercorporeality, or the ‘incarnation’ of intersubjectivity, goes beyond the mere being
together of subjects. It implies that “the own and the alien are entangled, that everybody is
inserted into an interlacing” without readymade individuals (Waldenfels 2004, 246).
Individualization only follows from this pre-existing anonymity of the intercorporeal being
(Merleau-Ponty 1968, 143). This does not mean that the individuation and distinction between
self and other disappear in total. Merleau-Ponty is equally clear in claiming that a ‘dehiscence’
or divergence (écart) is evident in every embodied situation (Reynolds 2002, 68). Touching and
being touched, looking and being looked at, or the sentient and the sensible, undeniably show
this divergence. It is in fact a necessary or constitutive factor for subjectivity in the first place.

2.1.4 Sociality and personhood

As is well known, Husserl’s pure ego is not a concrete element of experiences, but it is
rather one of the poles of intentionality (Husserl 1973b, 26). In other words, the pure ego or the
I-pole is not the reflected or thematic I which I may find when thinking about my experiencing,
but it “lives” in the acts (Husserl 1973a, 246). “One cannot find an I in experience, but only
experience as such” Husserl famously said (Husserl 1973a, 246). One could then easily conclude
that Husserl defended a non-egological position, as argued in the introduction of this work.
However, the specific emphasis on the pure ego or the I-pole leads to the conclusion that,
although Husserl claims that there is no such thing as an independent self to be found in
experience, he does identify a “superior subject” (oberstes Subjekt), which is capable of
identifying the experiences as mine (Husserl 1973a, 303). The following subsection is not
intended to fully clarify all ambiguities within Husserl’s ideas on the presence or absence of an
ego, but it rather expands the inquiry on how the pure ego relates to the I in the world. Husserl’s
pure ego is not specifically embodied, nor is it a determined personality (Husserl 1973a, 303;
Bernet et al. 1996, 192). It is transcendental, whereas the mundane ego is not. Husserl
acknowledges indeed that the mundane ego emerges from interpersonal contact and becomes
personal self-consciousness, from “the community of will and joint intentions, mediated through
communication” (Husserl 1973a, 170).
The main question discussed here is then: how does social interaction form personhood?
How the other is apperceived has already been discussed. The question is to what extent do I
have to be apperceived myself in order to apperceive the other. Should I already be self-aware of
being a person before I can appresent the other as person? Is a person different from the
transcendental ego inasmuch as I am perceived by others and that I have object-like

68
characteristics, such as my body (Husserl 1973a, 431)? It has been claimed that the perspective
of the others offers me a unique kind of self-apprehension (Zahavi 1999, 164). Moreover,
according to Husserl, the personal I, just as any object, has to be constituted noematically
(Husserl 1973a, 246). The noematic I or object-I is an I for others. The correlated noesis is
therefore a social or intersubjective noesis, because I only become an object-I or noematic I in
the eyes of others. It is then concluded that: “Empathy and the further developed social acts are
the origin of personhood. For personhood, the subject’s self-awareness of being a pole of his acts
does not suffice, but personhood is only constituted when the subject relates to other subjects
socially” (Husserl 1973b, 175). The social subject thereby gains persisting characteristics and
develops for himself and in community with others. Husserl’s sporadic use of the term
‘monadology’ to describe his idea of intersubjectivity has already been mentioned. Overall, the
monad metaphor is used to bring together all essential elements forming the subject: it is the
whole of the stream of consciousness, the transcendental ego, the I-pole in intentionality, the
person with drifts, habits, and a history (Altobrando 2011). Interestingly, with regards to this
metaphor, a certain shift within Husserl’s ideas on intersubjectivity can be registered. As
previously explained, Husserl early on claims that the monads have no windows and there is no
relation to other monads (Husserl 1973a, 7). Later, he modifies this idea: “It is not as if every
monad is just for-himself… and as if it could only be that way without other monads, but no
monad – in so far as the others are ‘constituted’ intentionally (just like everyone constitutes his
past in his presence) – could exist without the others” (Husserl 1973c, 194). Elsewhere he also
argues that a pole is unthinkable without a real surrounding world. There is no I without a not-I
which the I can intend (Husserl 1973a, 244).50
One last element that clarifies the role of sociality for the mundanization of the pure I is
narrativity. It has been argued in the introduction that the narrative self is a self co-authored by
the person and his surroundings. We live in the stories that are told of us and by us (Schechtman
2011). Narrativity is then one element of sociality. It makes our practical involvement in the
world and with others seemingly coherent and unified. Arguably, in order to become a person,
one needs a narrative (Zahavi 2008, 128). The pure ego does not yet have a narrative, as it is pre-
reflective and inaccessible to others,whereas narrativity relates the pure I to its social
surroundings.

50
For the purpose of this inquiry, this point is most relevant because it shows that Husserl struggled to find a
correct phenomenological description of how the self relates to others, and to what extent intersubjectivity is
involved in the ‘deeper layers’ of subjectivity. The monadology, especially in the context of intersubjectivity,
often remained unclear and it does not offer us a clear tool to analyse the relation between self and other. See
Altobrando (2011, 149) for further elaboration.

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 Husserl’s position is adamantly clear: the person emerges from social interaction. It
remains open to debate whether the more fundamental I-pole or transcendental ego can exist
without others. Undoubtedly, there is a clear-cut conceptual and phenomenological distinction
between the pure I (reines Ich) and the person. Only the latter is explicitly social, while the
former might only require intentional opposition or otherness under the form of a real
surrounding world of objects. Previous sections have explained, however, how the experience of
a real world already requires the presence of others. In the following section of this chapter, this
point is discussed in more detail. It can be concluded anyhow that the personal I is a combination
of the pure I and its habitualities, the object-like character of its body as experienced by others
and its narrativity. How the pure I and the social or personal I are connected, remains however
unclear (Moran 2012, 240). It might be contingent on the field of inquiry itself, namely whether
the research is dealing with the transcendental or the mundane.

The questions and uncertainties that impede social interactions for schizophrenic patients
are strongly related to the philosophical topics here under discussion. How are we connected to
others, while still distinct and individual persons? How do I separate my experiences from
yours? How can I understand you, despite the inaccessibility of your experiences or your
subjective life to me? And how could I make myself understood? Husserl’s phenomenology
allows the dissection of these questions. Even though many useful elements can be found in his
work for the study of intersubjectivity, such as his ideas on empathy, on the constitution of the I
through the not-I, and on the development of a mundane subject in social interaction, he
regrettably does not account for other forms of intersubjectivity, including the ontological
connection to others. Merleau-Ponty, Heidegger, and Waldenfels shifted the weight of the
investigation more towards the others, thus indirectly contributing to the phenomenology of
schizophrenia beyond Husserl’s concepts, notably through the concepts of intercorporeality and
indirect dialogue.
Nevertheless, the symptoms, signs, and phenomena of schizophrenia are clearly not
restricted to encountering and understanding others, but they relate to the intersubjective
experience of the world and of reality as well. Therefore, before moving on to Chapter 3 and
analysing the intersubjective dimensions of the schizophrenic alteration, a second kind of
intersubjectivity, which is related to the subject’s experience of the world with others is to be
examined.

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 2.2 The shared world - I, the other, and the others as co-constituting

2.2.1 Intersubjective reality in phenomenology

The inquiry now enters a different domain of intersubjectivity. This domain is no longer
concerned with direct encounters and how these encounters are possible. The focus now shifts
instead from the dyadic interaction between people, towards the triadic relation with others and
with the shared world. It will be thus investigated how intersubjectivity plays a role in our
experience of reality. Intersubjectivity is taken to be much more than the interaction of bodies
and subjects apprehending each other through analogy and appresentation. Arguably, every
experience we have refers to others and each reference is part of intersubjectivity. Moreover, two
of the most thought-provoking symptoms of schizophrenia concern precisely intersubjective
experience, namely delusions and hallucinations. A thorough analysis is therefore needed of
what intersubjective world-experience or intersubjective reality is.
In what follows, the reader will become even more familiar with previously introduced
philosophers’ agendas and explicit suggestions on the topic. Schütz, for example, claims that
“the clarification of the sense-structure of intersubjectivity and of the world accepted-by-me-as-
objective is, and remains, a legitimate task for phenomenological constitution analysis” (Schütz
1966, 84). Furthermore, Zahavi remarked that if Husserl’s idea that reality is constituted
intersubjectively is to be taken seriously, it implies that the transcendental inquiry has to be
expanded towards the intersubjective sphere (Zahavi 2009, 139). This conclusion is particularly
pertinent. The role played by intersubjectivity in our experience of reality on a transcendental
level is so to speak unproblematic. However, intersubjectivity itself does not remain restricted to
the transcendental, as we encounter intersubjectivity first and foremost in the world, in the field
of everyday experience. The following task, therefore, comes to the fore: intersubjectivity
requires to be studied in the world, on both a transcendental and an empirical level, and both
within the unitary harmonious intersubjective experiences, as within experiences of disharmony
and difference between subjects, as encountered for instance in schizophrenia.
The problem of reality, and more specifically the involvement of intersubjectivity in its
constitution, is a major theme in Husserl’s phenomenology (Zahavi 1996). As is well known, he
was certainly less interested in a theory of what reality would be ‘an sich’, and more in how
reality is constituted. However, Husserl’s theory on how we experience others, which has been
discussed in the previous section, does not offer much clarification concerning a transcendental
community or a transcendental We. Notwithstanding, this is required in order to discuss
intersubjective reality. Without such a clarification, the overall perspective would be restricted to

71
a world populated by others, to whom I ascribe a subjective life based on the appearance of their
bodies, as constituted by one transcendental ego, namely my own. Unfortunately, this does not
bring us any closer to understanding reality, objectivity, or the transcendent. If one was to argue
that it does, this would mean that “we were to define community in such a way that, contrary to
meaningful usage, there would be a community for me, and one for you, without the two
necessarily coinciding” (Schütz 1966, 76). Finally, two different definitions of intersubjectivity
can be possibly ascribed to Husserl. The first defines intersubjectivity as the constitution of an
objective world including the encountered others. According to this perspective, community
means nothing more than a primal ego, i.e. the philosopher performing the epoché, who imagines
a world where others are also transcendental egos. Intersubjectivity would therefore be a
plurality of transcendental egos. The second definition refers instead to some kind of already-
present and passive community, which precedes its revelation in communication or in empathy.
As Waldenfels (1971, 143) has pointed out, this second kind of community does not create the
common world, but it shows it. Intersubjectivity actually unfolds or reveals a passive
community, prior to the active phase of communication. It is this form of intersubjectivity which
comes to the fore when the intersubjective constitution of reality is discussed not in the I-Thou
relationship, but in the experience of reality and the world.

2.2.2 Intersubjective perception

The first step towards the phenomenology of intersubjective reality concerns perception.
Husserl famously developed a theory of perception, where objects can either be given originally
or not-originally (Husserl 1973a, 347). Original means that the intention is fulfilled, and the
object is originally there. But, as it has been argued with regards to how I presentify the
subjective life of the other based on the original givenness of their body, it is clear that I never
perceive the totality of an object originally. The more sides and parts of an object I perceive, the
more originally the object is given to me. By perceiving an object as object, including the sides
and parts which are not originally given to me, such as the backside of the chair I am looking at,
I immediately co-experience the possibility of fulfilment of my ‘empty intentions’. If I were to
walk around the chair, I would perceive the backside originally.
Therefore, my perception of an object and the correlated experience of the reality of this
object depend on the possibility to have multiple experiences of the object (Husserl 1973a, 181).
However, it does not suffice that I could have possible experiences of the same object if I were to
change my position and my perspective. We seldom change our position or our perspective on an
object to experience it as that object or to experience it as real. In fact, we do not question the

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reality of it at all. We immediately perceive it in its totality or ‘horizontally’, without the need for
consequential different perceptions. Accordingly, Husserl is forced to add an essential part to his
theory of perception. The other possible perspectives are not my possible perspectives. The other
possible perspectives and the consequential reality and totality of the object depend on the co-
perceptions of other subjects. The only way in which I am simultaneously capable of perceiving
and apperceiving is by relying on the possible presence of other subjects who experience from a
different perspective.51 The plurality of possible subjects is the noetic correlate of the subject’s
noematic plurality of co-existing aspects (Zahavi 1996, 239).52
This highly significant turn is made explicit by Husserl’s use of the term ‘open
intersubjectivity’. “Ontologically, every appearance I have, is already part of an open and
endless, but not explicitly realized totality of possible appearances from the same (object), and
the subjectivity of these appearances is the open intersubjectivity” (Husserl 1973b, 289).
Regardless of whether other subjects are around, I co-experience them through my experience of
objects. Intersubjectivity is therefore already given prior to my encounter with concrete others.53
As previously explained, I appresent the other based on the object which I recognise to be a
body, namely through the gestures and sounds it makes. In order to experience this particular
object as a body, I already passively co-experience it within the framework of open
intersubjectivity. This issue concerning the priority of distinct kinds of intersubjectivity will be
further discussed later on. However, it should be clear that in order to experience objects as
objective, that is, as intersubjectively accessible, I do need the explicit presence of others at least
once.
Interestingly, Husserl wonders whether the appearance of objects is different for different
subjects. Certainly, the position and perspective of a subject determines what is originally given
of the object. Nevertheless, horizontal intentionality would make the object the same for every
subject. “Both of us have the same appearance-things, the same motivated sequences of
appearances as real things, the same thing-realities. The endless manifold of possible (motivated)
aspects (of the orthological manifold) is in a way common property for all subjects” (Husserl
1973a, 377).

51
For an extensive analysis of the simultaneity of intersubjective perspectives, and consequently an
intersubjective temporality, see Rodemeyer (2006) and Waldenfels (1971). For its relevance for
psychopathology, see Fuchs (2013d).
52
Yamaguchi (1982, 34) pointed out that apperception is motivated by a tendency towards the perception of
objects in their totality, therefore requiring open intersubjectivity. He describes this tendency on the lowest
layers of passivity and should not be confused with tendencies for knowledge on higher levels of experience.
53
As Fuchs has remarked, and as it will be argued further on, it is questionable whether developmentally
speaking intersubjectivity is already given “before” my first encounter with others.

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 Most of Husserl’s ideas on perception are based on normal or orthological experience. This
means that a subject experiences time, space, and causality according to a specific
proportionality. In other words, proportionality makes the “orthological perception” possible
(Husserl 1973a, 363). The orthological perception is just a ‘normal’ perception. Husserl means
nothing more than that a particular object is experienced under optimal form and integrated in
accordance (einstimmig) with the coherence and persisting identity of the experienced object,
and therefore with previous experiences (Husserl 1973a, 363). Interestingly, this kind of
experience postulates the object as being (als seiend setzen) (Husserl 1973a, 121). Furthermore,
in order to have orthological or normal experiences, the subject needs a body, regardless of its
completeness. Some parts of the body might be missing or anomalous, without interfering with
normal perceptions. Finally, the body functions orthologically as long as it puts the experiences
into a coherent and concordant whole (Husserl 1973a, 368). It should be remarked that the reality
of an experienced object, through accordance and integration into a bigger whole of experiences,
might be orthologically correct but still intersubjectively wrong or abnormal. The orthological
system of perception only concerns the coherence and accordance among the subject’s
perceptions. A blind man would therefore have an orthological system of perception, because all
of his perceptions are coherent and in accordance with each other. Things only become different,
abnormal, or heterological when brought on the intersubjective level of experience (Husserl
1973a, 368).
All things considered, it could be claimed that what I experience is the world as
experienced by others. “We are many subjects of sense (Sinnessubjekte), but with
communication we are able to share all senses, and in such a way that everyone faces a world,
which is built through all these senses, and that everyone knows that the world he faces is the
same for all”, Husserl claims (Husserl 1973b, 197). Communication is therefore a vital element
in our perception of the world.54 Communication essentially means that we relate our activities to
others, and vice versa (Waldenfels 1971, 139). It has its cause and goal in praxis. However,
intersubjectivity works on a much more passive level as well. Husserl claims that
intersubjectivity is a matter of consciousness, and it is manifested in both my behaviour and in
the sphere of my passivity, affection, and plain receptivity: “We orientate ourselves in our life of
senses, we orientate ourselves according to ‘our’ and not just to one’s own experiences” (Husserl
1973b, 197). Individually, and passively, then, we integrate the intersubjective into our
transcendental consciousness.

54
I use ‘communication’ (Mitteilung) as Husserl does, namely in its trivial meaning of verbally sharing each
other’s thoughts and experiences.

74
 It has already been occasionally claimed within this inquiry that an intersubjective reality
is the noema of a particular noetic act performed by intersubjectivity itself. But how could one
define this kind of overarching and shared subjectivity which determines our experiences of the
world? Husserl suggests that: “Personal consciousness becomes one with another, individual and
necessarily distinct consciousness, and thereby it becomes a unity of transpersonal consciousness
(überpersonales Bewusstsein)” (Husserl 1973b, 199). The transpersonal consciousness is
formed, Husserl writes, because of the human condition: “I have been in connection with others
for as long as I can remember”, and my understanding and interpretation of the world is formed
by the interaction with others, and it is formed that way again and again through interaction
(Husserl 1973c, 173). Transpersonal consciousness is thus just another name for transcendental
intersubjectivity and it emphasises on the one hand a structure which transcends the individual
subject, and on the other hand the integration of the community of subjects into the experience of
the world of the individual subject. Just as the individual subject has a sphere of original
experience, so too does transcendental intersubjectivity have a sphere of originality, which is
built through ‘communalization’ (Vergemeinschaftung). The constituted world in this original
sphere is the objective world. The transcendental We performs the intersubjective noesis, thus
constituting the world which is the same world for all subjects part of it. Transcendental
intersubjectivity, or the transcendental We, becomes finally realised (verwirklicht) in the
objective world (Husserl 2012, 107).
Husserl’s understanding of intersubjectivity in perception has been now thoroughly
discussed. However, one may still wonder how the purely subjective in Husserl’s
phenomenology actually becomes saturated by the transpersonal and intersubjective. This
amounts to an inquiry into the moment when some transcendence appears in the subject’s
immanence, namely the transcendence of transcendental intersubjectivity. How can
intersubjectivity become such a vital element of subjectivity? 55 With regards to perception, the
same question can be formulated as follows: how is it possible that, even in the absence of
others, I still experience the world and its objects as transcendent, as objective, as real?
The answer to this question points to the human condition of being with others as what
forms our categories of experience. Mundane intersubjectivity is the situation we find ourselves
in, again and again. It is, according to Zahavi, the first encounter with the other which forms our
categories. The first and most fundamental encounter with others constitutes objectivity, reality,

55
Merleau-Ponty asks the same question in The phenomenology of Perception (2005, 423): “The problem of the
existential modality of the social is here at one with all problems of transcendence. Whether we are concerned
with my body, the natural world, the past, birth or death, the question is always how I can be open to phenomena
which transcend me, and which nevertheless exist only to the extent that I take them up and live them.”

75
and transcendence. “This does not mean that these later experiences become meaningless, but
their role would be different. They do not enable the constitution of the categories of objectivity
and transcendence, but fulfil them” (Zahavi 2009, 122). So even when I am alone, or in
Husserl’s example, in case a universal plague left me as the sole survivor, I would still
experience the world through transcendental intersubjectivity (Husserl 2012, 93; 1973c, 5).
Similarly, in Heidegger’s Being and Time, we can read: “Being-with essentially determines
Dasein, even when no factual others are present-at-hand or perceived” (Heidegger 1967, 120).
Heidegger’s description of pre-predicative understanding is closely related to Husserl’s
previously quoted remarks, especially when he points to our pre-thematic and implicit trust in the
world, in its tools, and in the totality of references we encounter there (Heidegger 1967, 76, 104,
149-150). Along these lines, our cultural world is then understood as referring to others “beneath
a veil of anonymity”, as Merleau-Ponty phrased it. “Someone uses the pipe for smoking, the
spoon for eating, the bell for summoning” (Merleau-Ponty 2005, 405). Such a pre-predicative
understanding of the world based on interaction could be called ‘common sense’. It is some kind
of basic trust that develops from infancy, through the interaction with caregivers, and later on is
shaped by the continuous interaction with others. On the whole, it amounts to a deeply rooted
certainty in the presence of others (Merleau-Ponty 2005, 419) and in the presence of the world
(Heidegger 1967, 149-150). Husserl (2008, 251-256) refers to the original givenness of the world
56
as “Bodengewissheit” (fundamental certainty) , Heidegger (1967, 76) calls it “trust in the
world” (Vertrautheit mit Welt) and later Ludwig Wittgenstein (1969) refers to it as the
background or bedrock certainty of our language games.57
All these definitions refer to a pre-reflective, pre-thematic certainty which seems
incorporated in our actions and perceptions in the world. This is taken to be intersubjective both
in its origin and development, as well as in its regulation. The objects in the world are therefore
experienced as others experience them too (Waldenfels 1971, 140).58
The only distinction to be made here is that in the absence of others, our categories are not
confirmed by evidence. The presence of others and their perspective on the object gives us
exactly this: a fulfilment through evidence (Zahavi 2009, 122). Merleau-Ponty offers a helpful
counterexample. Hallucinations, he writes, lack some particular reality or “fullness”, inasmuch
as something is lacking which normally makes the object of our perception reside ‘in itself’, or

56
See (Summa 2014c, 321-322) for a brief discussion on “Bodengewissheit” and its relation to Husserl’s epoché.
57
Hubertus Tellenbach is quoted in Blankenburg (1971, 97) saying that trust is “the most grandiose prejudices,
without which Man could not develop himself”.
58
More recently, this is referred to as “shared intentionality” (Tomasello and Carpenter 2007; Leon and Zahavi
2015; Szanto 2015).

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act and exists by itself. The phenomenon is explained by the fact that the hallucination “does not
take its place in the stable and intersubjective world” (Merleau-Ponty 2005, 395).
Normal perceptions, on the contrary, are perceptions of objects in the intersubjective
world. Our perceptions and our categories of perception are regulated by intersubjectivity. These
categories are not only those of objectivity or reality, but also those determining the kind of
experiences we have. It is not the particular content of an experience that makes it
intersubjective, but the form of the experience, the category itself (Blankenburg 1971, 116).
Without once experiencing validation by others, I would not be able to attribute a sense of reality
to my perceptions. I would be able to say that I see a house, but I would thereby not believe that
the house I see exists (Husserl 2012, 18-19; Waldenfels 1971). In our practical involvement in
the world, or what Waldenfels (1971, 246) calls the “indirect dialogue”, we help each other
attune correctly to the shared reality, by validating and denying. But it is on the very
fundamental layer of passivity and receptivity that intersubjectivity already intervenes.
In a way, intersubjectivity finds itself in between the subject and the object. “The others
are neither part of my subjectivity, nor can they be mere object of experience in the world”
(Waldenfels 1971, 31). This “in-between” will be discussed together with the work of Japanese
psychopathologist, Kimura Bin, who claimed that the essential disturbance of schizophrenia
concerns precisely this in-between. Finally, while focussing in this section on the co-constitution
of the world, the concept of intersubjectivity has considerably shifted from the mundane
interaction with others towards a functioning element within each subject’s experiences, based
on a mundane and given sociality experienced through encounters.

2.2.3 The objectivity of the world

Husserl often refers to the surrounding world (Umwelt) to describe the realm of natural
attitude. It consists of the things in our everyday life. This includes the qualities of the things
perceived, but also the meanings, values, and utilities they have for us. The surrounding world
consists of two aspects: the natural and the personal. The natural surrounding world describes the
“mere materiality” of the world, while the personal surrounding world includes personal
constructs (personale Gebilde), such as opinions, meanings, and the implementation of cultural
traditions (Husserl 1973a, 426). “The surrounding world is the world perceived, remembered,
conceptually grasped by the person in his acts; it is the world of which the personal I is
conscious and to which it is oriented in its conduct” (Schütz 1966, 70). But the surrounding
world is not a solipsistic world. It has open horizons, therefore including the presence of co-
subjects, whom the subject encounters as persons. By matters of communication, the subject

77
lives not in a private world, but in a shared world, a common surrounding world as the correlate
of a plurality of subjects (Husserl 1973b, 197).
The subject and all other co-subjects take the surrounding world and the spatio-temporal
reality of it for granted. This is the general premise of everyday life, it is the implicit assumption
of any natural attitude (Husserl 2012, 82; Schütz 1966, 51). How is this possible? It has been
argued earlier that the perception of an object relies on possible perceptions by others (Husserl
1973a, 479). However, when concerned with the spatio-temporal reality of the objects, the matter
becomes more complicated. Indeed, we experience objects in our surrounding world as
‘objective’: we experience them as not only there for me and not only there in my immanent
experience. ‘Objectivity’ is a mundane rather than transcendental feature. It indicates that an
object is experienced as intersubjectively constituted, “as present for everyone” (Husserl 2012,
96). The ‘object’ of my experience is objective when I perceive it as identically perceivable and
expressible by others. 59 Objectivity is therefore defined as intersubjective validity (Husserl
1973b, 107, 109). Furthermore, objectivity does not only concern ‘objects’ or things, but also
events and activities. I experience these as public (öffentlich), not as private (Husserl 1973c, 5).
Intersubjectivity in its mundane form, namely, the presence of other people, finally forms the
apperceptive horizon of all our perceptions (Husserl 1973a, 289; Zahavi 2009, 125). Concerning
in particular schizophrenia, it can be already anticipated that schizophrenic delusions manifest an
alteration precisely to this experience of objectivity, as the content of these delusions is
experienced as objective and private at the same time.
Intersubjectivity is therefore the subjective correlate of the objective world (Schnell 2010,
19). The transcendental We relates to the objective world in the same way as the transcendental
ego relates to his immanent world. However, as just argued, the intersubjectivity found to be a
necessary requirement for objectivity is mundane intersubjectivity, namely real persons in the
surrounding world. How are the mundane and the transcendental form of intersubjectivity related
then? And what is their respective role in the experience of objectivity?
According to Husserl, the objectivity of the world relies on the transcendence of the world.
I cannot experience something as objective, if it is ontologically bound to my immanent sphere.
In order to experience objectivity, there has to be transcendence. Transcendence appears first in
the encounter with the other. The other goes beyond my subjectivity, beyond my immanence.
The other confronts me with transcendence and inaccessibility (Husserl 1973b, 277; 1973a, 110;
2012, 92). Husserl claims that: “The experience of the other transforms the appearance of the

59
Not all objects of my experience are ‘objective’. The house I imagine is an object of my experience, namely of
my phantasy, and it lacks the quality of objectivity, because it is not intersubjectively accessible.

78
world for the self, in what characterizes it specifically, into an appearance of an ‘objective’
world, as it is ‘for everyone’. And all the ‘mystery’ of the phenomenology of intersubjectivity
resides exactly in this ‘addition of sense’ (Sinnesaufstufung) due to which the experience of the
other gives to the own world precisely the characteristic objectivity of the single and unique
world of everyone” (Husserl 1973b, 289). The mystery arises as soon as one wonders how these
ideas on objectivity are compatible with the transcendental ego and its primordial sphere.
Husserl’s mysterious answer runs as follows: “By using the proper (eigene) the subject
constitutes the ‘objective’ world, as a universe of a being which is alien to him, and the first step
involves the alien of the modus of the alter ego” (Husserl 2012, 110).
In the previous section of this chapter, empathy has been mentioned as playing a role in the
formation of objectivity. In other words: “Now an ‘alien body’ appears in between the solipsistic
things, and thereby a completely extraordinary transcendence” (Husserl 1973b, 8). Because of
empathy, as the phenomenon where a subject appresents another subject based on the appearance
of his body, the natural world I experience is changed from my world to the common world. The
world is therefore no longer exclusively the correlate of my experience, or the noema of my
intentional acts, but it additionally becomes the world of others subjects and the correlate of their
experiences (Husserl 1973a, 228).
One further aspect of experience has remained underrepresented so far, namely affectivity.
The intersubjective validity is not only achieved through active communicating and comparing
of experiences, by a process of validating and refining our experiences with others. It is also
achieved through shared affectivity. “A certain inexpressible community is formed by the
sharing of the mere sensed. The full actuality is reached, not when we can potentially perceive
the same (as in open intersubjectivity and apperception), but when we are affected by the same.
And when we are interested in the same, and react in the same way (…) This is the only way in
which we experience the world as the same for each other” (Waldenfels 1971, 152).
Objectivity is thus defined as intersubjective validity. Objectivity depends on empathy,
Husserl argues, since this is the primal way of understanding the transcendence of the other, and
therefore, the transcendence of the world. It is worth remarking, however, that this position is not
unproblematic, and it will be clear in the last subsection that it constitutes one of the key issues
of the phenomenology of intersubjectivity, namely with regards to the question of what kind of
intersubjectivity is implicitly assumed to be a priori.

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2.2.4 Normality
In the surrounding world, we do not only encounter people who experience the world the
same way we do. We soon discover that people have different opinions and different values, and
they can also experience the world differently. Some people do not act according to the rules of
everyday life and they might experience truth rather differently. Husserl writes that mad people,
just like animals, are experienced by us as being there, but they do not contribute to the
intersubjective constitution of the world (Husserl 1973c, 162). Usually, he says, we do not argue
with these people. One cannot discuss with ‘abnormal’ people. Clearly, this is hardly a
phenomenological stance. Especially the application of this idea in psychopathology and
psychiatry would exclude all experience different from ours, which would mean the exclusion of
all kinds of deviations proper to human life, and therefore the end of psychiatry and
psychopathology as such. However, we should not understand this strange phrase by Husserl as a
maxim, but rather as an observation.
Normality is clearly an important concept for Husserl. The reader might recall how he
describes the orthological experiences as the standard. Now the question is what kind of
normality Husserl has in mind. It might be that, despite his seemingly condescending
terminology about ‘the mad’ (Wahnsinnige), there is truth in how he understands normality and
deviation.
First of all, the objective world as previously described, is the world as experienced by
everyone. However, ‘everyone’ means only the normal subjects (Husserl 1973a, 240). The
abnormal subjects, with heterological systems of experience, would only be considered normal if
most subjects experienced the way they do (Husserl 1973a, 379). Normality is thus not only
related to having the same capacities of experience as others, but particularly to having the same
as most other subjects have. Normality is therefore also conventional (Zahavi 2009, 140). It is a
form of intersubjectivity where rules determine the inclusion and exclusion by the community
(Husserl 1973c, 133-142). “A communicative plurality of people, in which usually (in der Regel)
the subjects have the same orthological system and subjects with a deviating orthological system
are ‘exceptions’, would be called normal human kind” (Husserl 1973a, 378).
Normality is thus strongly related to individual experience. In other words, mundane
intersubjectivity is related to the subject’s transcendental experience: each subject anticipates
normal experiences, and expects certain patterns in his or her experiences, which are inherited
from our predecessors and acquired in the interaction with others (Zahavi 1996). As individuals,
we expect or anticipate the following experiences to fit with previous experiences. If I have a
deviant experience, which clashes with my previous experiences and with my anticipations, I

80
will modify these further on (Husserl 1966a, 25). Normality is thus not just a matter of
conventions and social in- and exclusion. It is a categorical part of the subject’s transcendental
experience. The traditional and historical intersubjective patterns of experience, of anticipating
the normal, and what the normal consists of, are integrated into the purely subjective sphere of
experience (Husserl 1973c, 137-138). I would go so far as to claim that the apperception and the
way we apperceive are inherited from others. This is an element of the previously investigated
transpersonal subjectivity (überpersonale Subjektivität).
Heidegger later confirms this view: “The They (das Man) 60 influences the mood
(Befindlichkeit) 61 , it determines what and how we ‘see’” (Heidegger 1967, 170). Waldenfels
stresses the conventionality and regulatory function of normality even more: “In the organisation
of the community we set particular rules, we make explicit conventions which we have to
respect, explicit particularities are determined and attached to us” (Waldenfels 1971, 335). On
the whole, it wouldn’t be fair to claim that Husserl’s normative view prioritises normality as
such. He rather describes in a phenomenological way how normality functions, as Heidegger and
Waldenfels have done too, both on the level of mundane intersubjectivity in the society of
people, and on the transcendental level of intersubjectivity.

2.2.5 Subjectivity in an intersubjective world

Certain dimensions of intersubjectivity are an integral part of the subject’s individual
experience of the world. On the lowest layer of passivity, intersubjectivity is recognized under
the form of apperception of objects through open intersubjectivity and on the basis of being
commonly affected. Also on this level, the inherited and acquired categories of our experience
are to be found. On higher levels, the subject integrates common cultural and personal rules that
determine the individual’s expectations of normality. Nevertheless, the subject remains
individual, that is: not entirely assimilated by the community of subjects. This is the case for a
person in interaction with other people, but it also holds true for the subject’s individual
experience of the world. “The introjection of sensations and appearances into the subject, or the
idea that these are merely subjective, originates in intersubjectivity” (Husserl 1973a, 388).
Subjects thus become aware that the perspective and position they holds are essentially theirs.
The others do not experience it exactly as the subject does. Therefore, the subject’s own
experience of how the world appears is relativized. The truth as discovered in the primordial

60
‘Das Man’ is alternatively translated as ‘the One’, from the English expression ‘One does this’ (e.g. Schatzki
2007). I chose to use ‘the They’ because it indicates that ‘das Man’ is related to an anonymous plurality of
persons.
61
Other translations for ‘Befindlichkeit’ are disposedness, state-of-mind, affectivity, affective self-finding.

81
sphere by a still solipsistic subject is later “characterized as a subjective truth” (Husserl 1973b,
131).
Part of this process is the recognition of one’s own world of experience as an aspect of the
world (Husserl 1973a, 304). Empathy, or the experience of the other in general, provides an
experience of transcendence and consequently of objectivity. But not only that, it also provides
hints to the relativity of any subjective experience. By becoming aware that the experienced
object is also experienced by others, I simultaneously become aware of the difference between
the thing itself and the thing as I experience it (Zahavi 2009, 123). This realisation requires the
recognition of other bodies as other subjects. A subject aware of intersubjectivity is also a
subject aware of the distinction between the inner and the outer world. This is not a spiritual
concept, but rather a description of the sphere of subjective originality (Eigenheitssphäre) as
apposed to the sphere of intersubjective originality. “I distinguish between a) that which I find in
my self, independent of others, in my own intentional field as worldly and as the world itself,
and b) that, which I find with the ‘help of others’, being the objective world that is there for all of
us” (Husserl 1973b, 385). As it will be made clear in chapter three, this description greatly
contributes to the understanding of schizophrenic delusions, namely when the patient makes
statements about the outer world with the apodicticity of experiences of the inner world (Spitzer
1989).
To conclude this brief subsection on the relativity of subjectivity, one could say that
experiencing the other is both a fruitful and necessary condition for the experience of the world
as out there. Nevertheless, it also limits the domain and quality of our individual experiences.
The subject becomes somehow self-alienated and decentralized through the awareness of other
subjects (Zahavi 2001; Rodemeyer 2006, 191). Not only do these other subjects perceive me
indirectly, that is, as I perceive them, namely firstly as an object. But it furthermore throws the
subject back to its own subjectivity, now aware of the relativity of this subjectivity. After the
encounter with others the subject will be different. He or she will no longer be a blind solipsist.
They will have learned about reality, objectivity, and transcendence, but simultaneously about
their counterparts: appearance, subjectivity, and immanence (Zahavi 1996).
The discussion of intersubjectivity usefully clarifies Husserl’s assumptions on subjectivity.
The priority of the subject over intersubjectivity is essential to his ideas. However, Waldenfels
sees this differently: “We do not have two original spheres, which firstly have to be united, but
we have one sole sphere, which allows isolation and explicit unity” (Waldenfels 1971, 156).
After this one sphere becomes individualized, the subject is able to relativize its own perspective.
“Thereby motives appear for the distinction between fiction and reality (Schein und

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Wirklichkeit), because the naïve equation of these two becomes obsolete in the (intersubjective)
exchange of experiences” (Waldenfels 1971, 176).
Heidegger, on the other hand, famously described how Dasein could lose itself in the
world, and more particularly, in the everyday ‘dictatorship of the They’. “Everyone is the other,
and no one is himself. The They, which supplies the answer to the who of everyday Dasein, is
the nobody to whom every Dasein has always already surrendered itself, in its being-among-one-
another” (Heidegger 1967, 128). The They is what prescribes how we ought to be, how we are
with others, and how we isolate from others. However, it should be remarked that it is not Dasein
itself, but rather the They-self, that Heidegger distinguishes from the authentic (eigentliche) self.
In order to become authentic, Dasein has to clear away coverings and obscurities and break up
the disguises with which Dasein cuts itself off from itself. Thus, Dasein can disclose its own
authenticity and discover the world (Heidegger 1967, 129). This is of course not the only kind of
intersubjectivity within Heidegger’s theory. The other kind concerns the other Daseins I
encounter in the world and through the world, with whom I care.

2.2.6 The problems of transcendental intersubjectivity

Alfred Schütz, who has been quoted multiple times in this chapter, titled his article on
Husserl’s ideas on intersubjectivity ‘The problem of transcendental intersubjectivity in Husserl’.
One of his main conclusions is that Husserl’s phenomenology fails to solve the problem of
intersubjectivity. The reason for this is that it admittedly remains within the transcendental
sphere, while disregarding the role of intersubjectivity as given in the world. According to
Schütz, the role of mundane intersubjectivity should be fully reappraised: “I strove to show that
Husserl’s failure to find a solution to this problem is due to his attempt to interpret the
ontological status of social reality within the life-world as the constituted product of the
transcendental subject” (Schütz 1966, 87). Husserl’s attempt necessarily fails, because only an
“ontology of the life-world, not a transcendental constitutional analysis, can clarify that essential
relationship of intersubjectivity” (Schütz 1966, 82). The problem of intersubjectivity would thus
not be a problem of constitution, which could be solved in the transcendental sphere, “but it is
rather a datum (Gegebenheit) of the life-world”. The problem of solipsism, glooming over the
whole discussion on intersubjectivity, only appears because of the neglect of the “founding
mundane intersubjectivity” (Schütz 1966, 83). This argument shows similarities with Fink’s
remark that Husserl’s phenomenology sometimes seems to disregard the mundane origin of its
content. The intramundane human situation, Fink claims, is therefore underrepresented in
Husserl’s phenomenology of intersubjectivity (Fink in Schütz 1966, 86).

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 The phenomenological discussion in this chapter gives raise to important questions. The
first question concerns the problem of priority. What is first, transcendental intersubjectivity or
empathy? According to Zahavi (2008, 168), this remains the main issue in the phenomenology of
intersubjectivity today. It has been argued here that empathy and the encounter with others are
necessary conditions for the experience of transcendence, and therefore, for objectivity. The
transcendence of the world would then be a condition for perceiving objects in their totality, that
is, as transcendent objects, existing beyond the sphere of my immanence. Transcendental
intersubjectivity, and more specifically what Husserl calls the intersubjective horizon, would
therefore result as a secondary phenomenon of our perception. The implicit risk in this claim is
that all intersubjectivity is reduced to empathy (Zahavi 2008). This could mean that other
dimensions of intersubjectivity are neglected. Another answer would emphasise the priority of
transcendental intersubjectivity, by arguing that every perception of the other, both as an object-
body and as a subject-body, requires perception through the open intersubjective horizon.
Transcendental intersubjectivity would thus already include co-subjects even before their
concrete presence. 62 This means that already on the lowest levels of experience, the level of
passivity and of the pure constitution of objects, this kind of intersubjectivity would play its role,
not just on higher levels of meaning, value, and judgement (Husserl 1973a, 348). In this view,
transcendental intersubjectivity is a necessary element of every kind of perception, and it would
therefore be present prior to the concrete encounter with the perceived other. Empathy and the
experience of another subject would then be considered as manifestations of the more
fundamental form of intersubjectivity (Husserl 1973a, 348).63
The second question is how the mundane influences the transcendental. Is the mundane
We, which includes sociality, being with others, and the others as already-there, a condition for
the emergence of the transcendental ego? Schütz would claim that it is: everything, from self-
reflection to performing the epoché, and therefore discovering the transcendental ego, emerges
from the concrete We-relation (Schütz 1966, 82). Husserl writes in the Cartesian Meditations
that the transcendental ego always requires what is not, namely otherness, as opposed to the

62
This is not unproblematic. We have seen that the problem of the apperception of an object involves the
impossibility to simultaneously perceive the other sides originally. The answer to this problem would be the
original givenness of these sides to possible others. However, the infinite sides that are not originally given to
me, would therefore have to be given to infinite possible others. This seems to be a metaphysical answer to an
epistemic problem. Concretely, we could ask whether the hypothetically solitary individual who never
encountered others would be unable to perceive objects in their totality or their ‘Gestalt’. Thanks to Michela
Summa for indicating this problem.
63
From a developmental standpoint, such argumentation makes little sense. We have seen how young infants are
related to others, in what Trevarthen called ‘primary intersubjectivity’. These infants are in an empathic
connection to others. It would be hard to claim that there is a phase priori to this earliest form of empathy, where
the child already experiences and perceives with the help of open intersubjectivity as Husserl described it.

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proper sphere of originality of the ego (Husserl 2012, 104-105). The question is whether Husserl
conceived of this otherness as another subject or as everything, including objects, defined as
‘not-I’ (Husserl 1973a, 244). In the Cartesian Meditations he claims that the first alien and not I
is the other I, the other subject (Husserl 2012, 106). However, as already pointed out, in his
earlier texts on intersubjectivity, he wrote, on the contrary, that otherness is not per se the
otherness of a another subject (Husserl 1973a, 30). One should then conclude that on the
transcendental level, intersubjectivity is always there in our experience of the world through
open intersubjectivity. The concrete encounter with the other, or mundane intersubjectivity, is
nevertheless necessary for the formation of our categories of experiences, for the validity of
these experiences and for objectivity. Objectivity depends on empathy, because this is the primal
way of understanding the transcendence of the other, and therefore, the transcendence of the
world. Further distinctions are required between intersubjectivity on the transcendental level, and
intersubjectivity on the mundane level, such as with objectivity.

2.3 Summary concerning Husserl’s successors on intersubjectivity

So far, Husserl’s phenomenology has been called upon as a starting point for the
clarification of the phenomenology of intersubjectivity. The development of his ideas has
provided useful tools to apply in the next chapter, in order to analyse the intersubjective
dimension of schizophrenia. However, not all of his ideas are unproblematic, and some aspects
of intersubjectivity remain neglected. It is therefore interesting to attempt and complement
Husserl through the multiple lenses of other phenomenologists. They all approach the problems
of Husserl’s theory of intersubjectivity from a different perspective. Indeed, we find elements in
their work that might contradict Husserl or each other, but which nevertheless offer helpful
insights to understand intersubjectivity in schizophrenia. A good example of this is provided by
the concept of intercorporeality, as introduced by Merleau-Ponty. Such an element was certainly
less prominent in Husserl’s theory of intersubjectivity, even though, as previously argued,
Husserl’s idea of the second or intersubjective reduction is an abstraction, thereby implying an a
priori unity of self and other. However, the overall idea is left open and it is only with Merleau-
Ponty that its importance was made fully clear. Since several phenomenologists have each
elaborated elements of intersubjectivity not thoroughly investigated by Husserl, I am keen on
briefly summarizing their respective positions and highlighting useful elements for the study of
schizophrenia and the next chapter.
Let us start with Heidegger. He makes clear in the introduction to Being and Time that he
was less interested in beings and more in the Being. His phenomenology shows how the Being of

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Dasein becomes clarified as a being-with-others (Heidegger 1967, 120). We encounter others in
and through the world. Empathy does not constitute our experiences of others, but being-with-
others is what allows empathy in the first place (Heidegger 1967, 125). Dasein experiences
others as Dasein as well, and this does not require appresentation. Understanding the other is an
essential part of understanding Dasein itself, as Dasein’s being is being-with. Apart from this
ontological intersubjectivity, Heidegger also describes how Dasein can become inauthentic when
it gets lost in the They. The They is a second kind of intersubjectivity in Heidegger’s work,
which mostly has a negative connotation, as it sometimes seems as if Dasein needs to withdraw
into isolation in order to become authentic. However, one should remember that Dasein is
neither a subject, nor an ego or a person, but it is rather the description of being-in-the-world.
Therefore, Dasein is permeated with world and others, it precedes or bypasses customary
dichotomies of object and subject, self and other, being a pre-reflective active and attentive
involvement in the world (Dallmayr 1980, 240). One further element of Heidegger’s theory,
which will be discussed in greater detail later on, is the “trust in the world” (Vertrautheit mit
Welt) (Heidegger 1967, 76).
As is well known, Merleau-Ponty considered intercorporeality, or the intersubjectivity of
the flesh as primordial. Intercorporeality is defined as a sphere of embodied sensibility and
reciprocal interaction. The moments of solitude and of communication are not excluding
extremes, but rather two moments of one single phenomenon: that others exist with me in the
flesh. Although my knowledge of the others is imperfect, their existence itself is beyond doubt
(Merleau-Ponty 2005, 419). Our relationship with the other is not intentional. Merleau-Ponty’s
view can therefore be clearly differentiated from Sartre’s. Sartre (1943, 293-295, 412) first of all
understands intersubjectivity under the aspect of confrontation with the other, such as what is
discovered when being looked at and in the experience of shame. Secondly, Sartre’s
intersubjectivity is strongly characterized by intentionality. Being looked at amounts to
becoming an object in the eye of the other-subject, whereas looking amounts to being the
subject, i.e. intending the other-object. Being subject or being object are the two fundamental
ways of being and, in intersubjectivity, we just seem to oscillate between these two (Reynolds
2002, 69). The other is therefore always other, and the We is only secondary (Sartre 1943, 467).
In Chapter 3 it will become clear that the otherness of the other plays an important role in
schizophrenia: otherness can be both a threat, as in experiences of transitivism, but otherness
may also be objectified, thereby annihilating the other’s otherness, as it has been described in
certain schizophrenic delusions.

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 Differently, according to Merleau-Ponty, ‘We’ are in contact “by the mere fact of
existing”, long before any type of intentionality or objectification (Merleau-Ponty 2005, 421).
This means that Merleau-Ponty considers the social to be a priori: “The social is already there
when we come to know or judge it. (…) Prior to the process of becoming aware, the social exists
obscurely and as a summons” (Merleau-Ponty 2005, 422). Merleau-Ponty would, however, not
deny the individual its existence. His crucial move is to open up the borders between subject and
object and between individual and social. “Our birth, or, as Husserl has it in his unpublished
writings, our ‘generativity’, is the basis both of our activity or individuality, and our passivity or
generality—that inner weakness which prevents us from ever achieving the density of an
absolute individual” (Merleau-Ponty 2005, 497). The reader is already familiar with Merleau-
Ponty’s pre-existing unity, however, it should be added that he also describes a dehiscence. This
dehiscence unfolds my body into two: the body as looked at and the body as looking, the body as
touched and the body as touching. This implies an overlap or an encroachment, “so that we may
say that the things pass into us, as well as we into the things” (Merleau-Ponty 1968, 123).
Intercorporeality is thus an essential dimension of intersubjectivity, interconnecting my
consciousness and my body with the phenomenal body of the other I see over there. This causes
the other “to appear as the completion of the system” (Merleau-Ponty 2005, 410), namely, of the
anonymous and intercorporeal being (Merleau-Ponty 1968, 143).64 The concrete experience of
intercorporeality can become clear ex negativo based on the deviation of affective attunement or
embodied resonance, which detaches the schizophrenic person from his surroundings.
Waldenfels (1971, 143), lastly, understood the subject and the other to interrelate in a unity
of dialogue, permitting individuation and isolation. He questions whether Husserl’s
phenomenological project, which is inherently restricted to the subject as such, would ever be
able to grasp the whole realm of the in-between of the dialogue, or of intersubjectivity in general
(Waldenfels 1971, XIV). Ultimately, Husserl’s project necessarily ends up with the problem of
transcendental solipsism or ‘acosmism’, as it attempts to bring intersubjectivity and sociality to
the constitution of a pre-social ‘Ur-Ich’. It starts with the reflection of an absolute self-certain I,
which should consequently lead to the properness of others and to the independence of the
world. This reasoning is faulty, Waldenfels argues (Waldenfels 1971, 403). The world, its
inhabitants and our joint praxis risk to become a spectacle in the ‘transcendental theatre’
(Waldenfels 1971, 125). Interestingly, this description bears much resemblance to certain

64
A detailed discussion on Merleau-Ponty and Levinas and their respective positions on intersubjectivity is
found in (Reynolds 2002).

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expressions of patients claiming to live life as in a movie or in a play where the others are
derealised.
While Husserl seeks to ground interaction and community on the transcendental ego,
Waldenfels proposes to look for foundations on the interactional or dialogical ego. This is the
ego in contact with others, who can subsequently isolate himself from others. Husserl’s
phenomenological method possibly already prevents a part of intersubjectivity, namely its
foundational role in experience, from being acknowledged. Indeed, the phenomenological
method reduces or excludes this intersubjective starting point. Yet on the other hand, to put the
We as primordial over the I, implies a certain form of self-forgetting (Waldenfels 1971, 402).
Therefore, the discussion on the primordiality or on the origin of We and I, of self and other,
should rather be a matter of accentuations instead of excluding alternatives.
It is clear that it is not just a matter of more or less emphasis on the social aspect of reality
that distinguishes Husserl from other phenomenologists. A truly different ontology determines
the role of intersubjectivity and the form it takes: whether intersubjectivity is the original way of
being, or the primordial unity of the flesh where individuality first emerges from; whether it is a
secondary manifestation of the primal encounter with the other in conflict and confrontation; or
whether it is a dialogical and therefore dynamic interactional sphere that allows us to be with
others as well as withdraw and be ‘our self’.

Conclusions

Section 2.1
The purpose of this chapter was to analyse and discuss the philosophy of intersubjectivity
that could offer helpful insights for the phenomenology of schizophrenia in the light of
intersubjectivity. By focussing on Husserl’s original ideas the inquiry was able to distillate the
essential questions in the debate. The first section of the chapter focussed on others as
constituted, namely intersubjectivity as we find it in encounters. Concerning how we understand
others, Husserl’s at times contradictory ideas on empathy were explained. Husserl notoriously
argued that we understand others on the basis of appresentation, which is a form of
presentification of the subjective life of the other, based on the appearance of a body that is
similar to mine. Husserl was aware of the inaccuracies of his theory on empathy, and anticipated
the critique that would later follow from Schütz and Heidegger. Later phenomenologists all
indicated that understanding others is less based on indirect inferential processes, as those

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described by Husserl, and pointed to an idea of direct grasping, for example through shared
involvement in the world, as it is the case for Heidegger.
The otherness of the other was discussed next, as the question arose how – if I were to
understand the other – I could recognise the difference between the other and myself. In reaction
to this issue, Husserl developed his theory of the alter ego, thereby highlighting the alterity of the
other. This implies that every understanding is limited and can only be a form of presentification,
rather than of original givenness. What determines mineness and otherness is the original
givenness in my primordial sphere. The other appears in my immanence, but as a transcendence.
Husserl argued that becoming a self is related to intentionality, namely to intending what it is
not. The I is therefore constituted through the not-I. Within his theory, it remained however
undecided whether this not-I is actually another subject or just otherness in general. Interestingly,
the issue of the origin of original giveness consequently comes to the fore: where the for-me-ness
or the original givenness comes from, if not from a prior distinction between me and not-me?
How am I to distinguish between experiences of the self and experiences of the other, i.e.
between originally given and not-originally given, if I can only distinguish these on the basis of
the prior experience of otherness and ‘ownness’? Husserl was expressing this very concern when
he wrote: “One should reduce towards the mere cogitations, towards pure consciousness; but
whose cogitations, whose pure consciousness?” (Husserl 1973a, 155). The whole issue can be
connected to Husserl’s implicit acknowledgement of the interdependence of subjectivity and
intersubjectivity, as he developed his intersubjective reduction as some kind of ‘abstraction’.
The alter ego theory was then refuted inasmuch as it seemed to assume that the other is just
a reduplication of one’s own ego. Sartre, for one, countered that the otherness of the other cannot
be neglected. Heidegger too disapproved of the alter ego theory, but he argued that the other is
firstly similar to me and to those among who we are, rather than entirely other. The otherness of
the other is manifested in the surprise and the appeal, as Waldenfels and Levinas claimed.
However, the otherness also plays a vital role in the objectivity of the world.
It has been argued that inherent to Husserl methodology is the tendency towards solipsism,
or at least the risk of interpreting phenomenological investigations in a solipstic manner.
Husserl’s primary interest was nevertheless the transcendental constitution of experience, and ,as
a result, the experience of others seems to be reduced to the consciousness of the reflecting
subject. However, a variety of references were provided where Husserl implicitly and explicitly
rejects solipsism. The most intriguing one concerns transcendental intersubjectivity, as
characterizing our experiences of the world. There the reader discovers that, even in the absence
of others, intersubjectivity still ‘functions’. Despite this element, which is admittedly not a strong

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denial of solipsism, Husserl was heavily criticized and warned against the risk of solipsism.
Schütz claims that Husserl neglected the mundane origin of consciousness and reflection, while
Heidegger’s Dasein is defined, possibly polemically, as intrinsically being-with-others.
Moreover, Waldenfels’ later dialogical phenomenology assumed that we are essentially in
dialogue with others and only acts of objectification of others would interrupt the connection to
others. Lastly Merleau-Ponty’s concept of embodiment offered strong arguments against
solipsism, as it starts from the assumption that we are incarnated in an intercorporeal being.
The last topic tackled by the first section concerned personhood and the question how
Husserl’s pure I is related to the concrete person. This remains open until today, but it was made
clear that the pure I becomes a body, at least partly, through the perspective of the other, and, as
a person, the individual develops habitualities, a narrative, and social features. Finally, it is in
sociality that the person develops.

Section 2.2
In the second part of the chapter the dimensions of intersubjectivity that belong to our
experience of the world, where others are primarily encountered as constituting or co-
constituting, rather than as constituted, were thoroughly discussed. The focus was on the triadic
relation with the shared world, rather than on the dyadic encounter itself. The reader discovered
how intersubjectivity appears in the world and how the world is experienced intersubjectively.
The analysis of our experience as an experience-with-others rather than our experience-of-others,
opens the domain of transcendental intersubjectivity. The question was raised how the
transcendence of the others is integrated into my own immanence, regulating how and what I
experience. Intersubjective reality has clearly many sides, and the relevant section discussed
some of the most central aspects of it.
Arguably, intersubjective reality only exists because of intersubjective perception.
Husserl’s famous theory of perception, including the introduction of apperception, leads to the
conclusion that possible others are included in the perception of an object. These possible others
are the ones that simultaneously grasp the unperceived sides of the object. This is called ‘open
intersubjectivity’ and interestingly, it challenges the idea that others are primarily encountered
through empathy. A question of priority appeared, namely whether we firstly have to encounter
the other through empathy and secondarily develop an intersubjective perception, which allows
for apperception under the form of open intersubjectivity. Or, whether open intersubjectivity is
preliminarily at work whenever we encounter others and appresent them as real existing beings
with a subjective life, given that empathic understanding of the other already requires the

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perception of his body in its totality, and thereby, the use of open intersubjectivity. From a
developmental perspective, it has been argued that open intersubjectivity could not be prior to
the encounter, as proven by how early infants are already in an embodied relation to others
without anything like ‘open intersubjectivity’ being present. In this view, open intersubjectivity
probably only develops after the first year, when Trevarthen described ‘secondary
intersubjectivity’.
In transcendental terms, Husserl called open intersubjectivity a transpersonal noesis. The
noemas of our perception are indeed intersubjectively constituted in such an intersubjective
noesis. He distinguished correct and incorrect perception on the basis of ortho- or heterology,
namely to the degree according to which a perception fits into previous and other perceptions.
The core of heterology, of deviating perception, is a lack of concordance with others. To
establish differences and deviations, but also to regulate perceptions, humans communicate with
each other, and thereby influence each other’s perceptions. It was then argued that the
intersubjective noesis is not just a transcendental idea, but is concretely realised as the We-
community that is already there. Lastly, intersubjective perception is not only a matter of
activity, but we are commonly affected also passively.
Since the question was how the intersubjective could influence and regulate the subjective
experience of the world, it has been investigated how Husserl, but also Heidegger, Merleau-
Ponty and Waldenfels described that we inherit the forms of experience or the categories from
others and that even in their absence, we apply these forms of perception onto our experience.
These are taken to be formed through interaction and they express how mundane
intersubjectivity helps to constitute transcendental intersubjectivity. A distinctive understanding
of the world was hence described, which becomes manifest in a pre-reflective, pre-thematic trust
in our perceptions and involvement in the world. This trust is intersubjective both in its origin
and in its development and regulation, and we could call it ‘common sense’.
Objectivity also depends on others, but on concrete others or real persons. We need the
experience of others to experience transcendence, namely that which transcends my immanence
and what exists therefore independently of me. The world is therefore no longer exclusively the
correlate of my experience, or the noema of my intentional acts, but it becomes the world of
other subjects and the correlate of their experiences. The We relates to the objective world in the
same way as the ego relates to his immanent world. The previously mentioned trust is a trust in
the objective reality of the world, which we achieve through active communication with others.
The world then becomes the world ‘for everyone’.

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 On an explicitly social level, our experiences are normative. This means that the
intersubjective community and conventionality decide on normality. Husserl described this
normativity, claiming that abnormal people, such as the ‘mad’, do not contribute to the common
experience of the world. Yet more interesting is that normality is strongly related to individual
experience. In other words, it was made clear how mundane intersubjectivity is once more
related to the subject’s transcendental experience. We anticipate normal experiences, we use
patterns in our experiences, which are inherited from our predecessors and acquired in the
interaction with others. This is an element of the transpersonal subjectivity (überpersonale
Subjektivität). This idea was then confirmed by Heidegger, who claimed that the They influences
the mood (Befindlichkeit) and the way we find ourselves in the world. Waldenfels would stress
this even more, and point to the conventionality or the rule-making as an essential part of
community.
Despite the emphasis on intersubjectivity in this text we did not neglect subjectivity itself.
It became clear that certain dimensions of intersubjectivity are an integral part of the subject’s
individual experience of the world. Both on the lowest layer of passivity and on higher layers of
conventionality and objectivity, we encountered the role of others as co-constituting.
Nevertheless, the subject remains subjective, that is: not entirely assimilated by the community
of subjects. Experiencing the other is both a fruitful and necessary condition for the experience
of the world as out there. But it also limits the domain and quality of our individual experiences.
In a sense, the subject becomes self-alienated and decentralized through the awareness of other
subjects. The own private experience becomes relativized or ‘subjectified’. As we will see, this
will help us with the description of schizophrenic delusions.
Lastly I recapitulated two critical questions in the whole debate. First there is the question
of priority. What is first, the encounter with the other through empathy or transcendental
intersubjectivity? Secondly, and closely related, how are mundane and transcendental
intersubjectivity related and how does one influence the other? A variety of answers to these two
questions is possible, most of which have been discussed in this text. It was also remarked that
different answers can be formulated depending on the adopted ontology. I concluded this chapter
with a brief overview of the different directions that the other phenomenologists went to criticise
and answer the problems of intersubjectivity. These critiques and ideas complement Husserl’s
theory, and they will be fruitfully employed in the analysis of schizophrenia in the next chapter.

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General conclusion of Chapter 2
In this chapter the role of intersubjectivity became clear on both levels: the mundane and
the transcendental, and in both situations: the direct encounter with the constituted other and the
shared involvement in the world with the co-constituting others. Through the reference to
Husserl’s original ideas and the addition of the other phenomenologists’ contributions, these two
forms of intersubjectivity could be balanced, without prioritizing and overvaluing one or the
other. I have accentuated different parts of the debate, without claiming it to be excluding
alternatives. Within the framework of the study of schizophrenia as a disorder of
intersubjectivity, several tools have been made available to come to a full phenomenological
description. The dimensions of intersubjectivity here encountered are: firstly, the interactional
mundane form of intersubjectivity, where we encounter others and others experience us as we
experience them; secondly, transcendental intersubjectivity, which enables perception through an
open horizon or open intersubjectivity, and which is related to normality and conventionality, to
objectivity, and basic or experiential trust. The core idea is that the subject experiences the world
through open intersubjectivity, common categories, shared affectivity, and through attuned
expectations and normality. All these elements determine the subject’s mundane
intersubjectivity, namely how one encounters, understands, and interacts with others. In these
interactions, cultural, normative and conventional aspects of intersubjectivity are deployed.
However, mundane intersubjectivity is not only the result, but also the origin of this
transcendental function of intersubjectivity, namely through the process of acquiring the
categories of our experience, regulated by the ‘indirect dialogue’. Therefore, a certain circularity
or reciprocity of intersubjectivity emerges. It will be now investigated whether and how the
different dimensions of intersubjectivity play a role in schizophrenia.

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 CHAPTER 3: THE PSYCHOPATHOLOGY OF
INTERSUBJECTIVITY IN SCHIZOPHRENIA
Introduction
This chapter examines the intersubjective dimensions of schizophrenia. It is divided into
two sections. The first section is a conceptual screening of major works on schizophrenia. In this
respect, I return to the roots of the self-disorder hypothesis through the lens of three classic
works on schizophrenia, namely by authors Emile Kraepelin, Eugen Bleuler, and Karl Jaspers.
Then, I take into account the contributions of phenomenological psychopathology, by analysing
the works of Eugene Minkowski, Kimura Bin, and Wolfgang Blankenburg. Lastly, I discuss
Chris Frith’s and others’ dominant neuropsychological theory, based on the idea that
schizophrenia is a disturbance of the ‘Theory of Mind’ and of ‘meta-representation’. Finally it
will become clear to what extent the self-disorder hypothesis relies on the traditional accounts of
classic authors and phenomenologists. One main question will guide this part of the inquiry: do
these accounts of schizophrenia already indicate disturbances of intersubjectivity, and if so, what
kind of disturbances exactly? Kraepelin’s and Bleuler’s contributions were undoubtedly
substantial, however the reader will remark that their impact was mostly clinical, and little
philosophical pondering was involved in them. From Jaspers on, the relevance of philosophical
insights for psychopathology has expanded significantly, as it will become clear in the account of
Jaspers’, Minkowski’s, Kimura’s, and Blankenburg’s ideas. The intersubjective elements
acknowledged in the work of these psychopathologists will prove to be more relevant than what
is generally assumed in contemporary phenomenological accounts on self-disorder.
In the second part of this chapter I investigate the clinical manifestations of schizophrenia,
and apply the conceptual insights of the first part to elucidate different phenomena, symptoms,
and signs from the perspective of intersubjectivity. These might appear very diverse, thereby I
structure their discussion according to the same distinction introduced in Chapter 2. The first
category will cover those phenomena, symptoms and signs that involve encounters and
immediate contact between persons. This corresponds mostly to mundane intersubjectivity.
Under the umbrella of the second category, I focus instead on delusions and on the disturbance
of co-constituting reality. This corresponds mostly to transcendental intersubjectivity. The
concepts and ideas introduced in Chapter 2 are here usefully employed as tools for the
phenomenology of the intersubjective dimension of schizophrenia. The main goal of this chapter
is finally to use both the philosophical insights of Chapter 2 and the psychopathological
descriptions of Chapter 3 to discuss the relation between self- and intersubjectivity disturbances
in schizophrenia.

3.1 Conceptual analysis of schizophrenia as an intersubjectivity disorder

3.1.1 Kraepelin
Emil Kraepelin (1856-1926) is still known as one of the most famous psychiatrists of all
times.65 Very famous is his view that a subtle description of disease states provides the best
possible contribution to the psychiatric field. He believed that psychiatrists should spend their
time describing pathologies, rather than speculating on aetiology.66 Another reason for his fame
is the distinction he introduced between two types of psychosis: the affective (or manic-
depressive) psychosis and dementia praecox (Scharfetter 2001). At the end of the 19th century he
also wrote a small compendium providing an overview of the illnesses he and his colleagues
were confronted with in the psychiatric institutions of the time. This small book would grow out
to become a real manual for psychiatry. It is in the 1896 fourth edition that he would for the first
time use the term ‘dementia praecox’ (Decker 2007, 339). The term itself was borrowed from
Morel, although Kraepelin’s use of the term differed significantly (Scharfetter 2001).
Before venturing into details concerning this concept and its intersubjective dimensions, it
is worth reminding the reader of Kraepelin’s own recollection of his first days in the asylum of
Munich in 1878. This may well help to understand the psychiatric praxis of the time from which
his ideas are developed. “The first impressions I had from my new job were disheartening. The
confusing hurry-scurry of countless debilitated, soon to be inaccessible and intrusive patients,
with their ludicrous or disgusting, sad or dangerous strangeness; the helplessness of the medical
acts, which had to be restricted mostly to greetings and the roughest corporal care; the complete
cluelessness of all these manifestations of madness, for which there was no scientific knowledge
at all, this all made me experience the heavy load of the profession I had chosen” (Kraepelin
1983, 12).
A large section of the seventh edition of his manual of psychiatry is devoted to dementia
praecox. Based on his own clinical experience, Kreapelin sums up the signs and symptoms of
this illness. According to him, dementia praecox is, however, not one illness with a clear
semiology, but it has to be understood as a collection of different clinical ‘pictures’
(Krankheitsbilder) or clusters of signs and symptoms. In what follows it is easy to notice that

65
The importance of Kraepelin’s work is discussed extensively by Hoenig (1983) and Decker (2007).
66
However, he himself did not always follow this advice (Decker 2007, 340).

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these clusters show little psychopathological coherence or unity. Kraepelin’s descriptions are
still useful nowadays inasmuch as they show a rather ‘naïve’, unprejudiced interpretation of the
symptoms and signs of the illness.
According to Kraepelin, the only common element for all types of dementia praecox is
their progression towards a state of deterioration (Kraepelin 1904, 176). Only few people
suffering from this illness are said not to progress into this end-state.67 He then distinguishes
three main subgroups. The first is the hebephrenic group, characterized by early onset. The
second is the catatonic group, which is characterized by the predominance of catatonic
symptoms such as negativism, stupor, stereotypical behaviour, etc. The paranoid group is the last
one, where symptoms of paranoia, or the persistence of delusions are most prominent.
On the whole, typical of dementia praecox is said to be its early onset, the progression, and
the end-state of debility (Kraepelin 1904, 177).68 Its cognitive impairments are taken to include a
diminishment of attention, a weakening of logical thinking and formal thought disorders,
including excessive associations, jumping from one thought to the other, distractedness
(Kraepelin 1904, 180). Listed linguistic disturbances include a loss of coherence of speech, the
formation of neologism and word-play. Another typical feature is recorded as stereotypical
behaviour. This means that, for long periods of time, patients keep on thinking the same
thoughts, stating the exact same sentences, and letting their activities be determined by these
thoughts. The patients’ capacity to judge is also accounted as disturbed, and Kraepelin writes
that any general overview is absent in their thoughts. He goes so far as to remark that some of
these patients do not really think (Kraepelin 1904, 181).
Other symptoms include disturbances of imagination and perception, such as delusional
perceptions (Trugwahrnehmungen). Although perception itself is only seldom altered, he does
note that certain delusions seem to be more powerful and convincing than perceptions (Kraepelin
1904, 178). Kraepelin furthermore describes hallucinations and illusions. Patients may hear or
see things that are not present, or may hear or see things differently. Often these perceptions
resemble feelings of streams through the body, of being touched, or being influenced. Delusions

67
Although Kraepelin did not want to speculate on aetiology, he did write in the introduction to the chapter on
dementia praecox: “Because of the clinical and anatomical facts, I cannot doubt that we are dealing with severe
and usually only partially repairable damage to the cerebral cortex” (Kraepelin 1904, 176).
68
Note that this idea of an overarching progression and the common end-state of debility is at variance with the
view of contemporary phenomenological psychopathologists. It is exactly the early stage with its prodromal
experiences, which is now believed to contribute the most to our understanding of the disorder. These prodromal
signs and symptoms are claimed to represent the core disturbance of schizophrenia in its purest form, before any
complex compensatory reaction (Sass and Parnas 2001, 352; Parnas and Handest 2003). Furthermore, the idea of
debility entails a strong emphasis on the weakening of cognitive functions, which are instead explicitly denied by
these phenomenological psychopathologists (Urfer-Parnas et al. 2010).

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might be so powerful that patients lose track of where and who they are (Kraepelin 1904, 177).
Delusions are often present and Kraepelin considered their content to be typical of each stage of
the illness: in the beginning they have to do with negativity and they can be about hypochondriac
fears, but also about being poisoned or persecuted. Later on, ideas of grandeur come to the
foreground. Interestingly, he remarks that most delusions pass, sometimes not completely, but
most of the time they seem to be forgotten after a while. It should be kept in mind that in
Kraepelin’s time no specific anti-psychotic therapy had yet been developed. Only in the paranoid
subgroup delusions are accounted as persisting for longer periods (Kraepelin 1904, 181).
Kraepelin furthermore hints at what I will later discuss as ‘double-bookkeeping’ or ‘double-
orientation’. He describes a patient who believes to be the ‘rex totius mundi’, but does not mind
working in the garden. Another patient claims to be ‘God himself’, but humbly carries wood
around, and ‘the bride of Christ’ is sewing and repairing clothes (Kraepelin 1904, 260).
Besides the cognitive and delusional alterations, Kraepelin describes changes in affectivity.
Most noteworthy is that the first sign of the illness is often a sudden change in the mood of the
patient, in his relations with others such as friends and family: “The curious indifference of the
patients for their affective relations, the loss of attachment with their family and friends, the
pleasure of activities and profession, of leisure and entertainment are not seldom the first and
most prominent signs of the start of the suffering” (Kraepelin 1904, 182).
Further on, he describes a loss of empathy, disgust, and shame. Interestingly for us, this
refers directly to different aspects of intersubjectivity: “The patients have no consideration
anymore for their surroundings, they do not attune their behaviour to the situation they are in”
(Kraepelin 1904, 183). He describes this disturbance utterly negatively, as he writes about the
patient not being interested in human norms. A loss of the feeling of worth is recorded, patients
molest each other, have no interest in their family, behave completely inappropriately, impose
themselves sexually to others, hurt themselves and others. One should not forget that Kraepelin’s
activity belongs to times when asylum care and psychiatric conditions were to say the least rather
upsetting (Shorter 1997). In his autobiography, Kraepelin recalls the conditions in the asylum of
Munich, where he was confronted with “150 demented, unclean, half-agitated and fully agitated
patients”, many of whom were incapable of work and would hang around in the hallways and
garden, “where they would run around, yell, get into fights with each other, collect rocks, smoke
and chatter. The tendency towards violence was widespread; almost none of the visiting rounds I
did were free of fights, window breaking and destroying of tableware” (Kraepelin 1983, 12). He
also recalls how hectolitres of beer were poured in order to keep the patients calm.

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 One last important group of symptoms concerns the loss of will and drive. Patients would
worry, remain inactive or, on the contrary, be excessively active without any guiding purpose.
Negativism is closely related to this loss of will and drive. Patient are described as resisting
against everything by closing their eyes persistently, by resisting to wear clothes or turning their
head away, by moving in the opposite direction, by mutism or senseless expressions. Kraepelin
further describes the phenomena of stereotypical positioning of the body, echolalia, and
echographia (Kraepelin 1904, 184).
According to his account, the general disturbance involves a loss of coherence or unity
between cognition, affection, and volition, what Erwin Stransky called “intrapsychic ataxia”
(Stransky 1987, 39). This lack of coherence should be recognizable in everyday expressions and
behaviour. He also characterizes these patients as unaccountable, as incomprehensible
(Kraepelin 1904, 186). Although this incoherence or loss of unity and the progression towards
the end-state of debility is supposed to be the most important characterization, Kreapelin
struggles with a coherent and concise overview of what he believes dementia praecox to be:
“The clinical presentation of the large field of dementia praecox brings up considerable
difficulties, because a demarcation of the different clinical pictures is only artificially possible”
(Kraepelin 1904, 191). From the perspective of the current research, three explicit intersubjective
elements can be outlined in Kraepelin’s description. Firstly, he describes how the first sign is
often a disruption in the affective connection to others. Patients develop a curious indifference
towards others with whom they previously had affective relations, leading to a loss of attachment
to friends and family. Negativism and mutism are distinctive expressions of this disconnection.
Furthermore, Kraepelin describes this interpersonal disconnection placing much emphasis on the
affective side of it. Secondly, through rather harsh descriptions he indicates that patients lose
empathy, decorum, disgust, and shame. They break with social norms and manners. Thirdly, he
points out that patients are incomprehensible, as a consequence of the disharmony in their drifts.
Unlike healthy people, who act according to the expression of their vision of life and
temperament, their impressions, considerations and moods, the person with dementia praecox
acts immediately, driven by inharmonious drifts, which makes them incomprehensible and
unpredictable (Kraepelin 1904, 186).

3.1.2 Bleuler
Eugen Bleuler (1857-1939) was a Swiss psychiatrist who is often mentioned as the
discoverer of schizophrenia. The exact role and influence of Bleuler is still debated today, but
what is certain is that Bleuler was the first to use the term schizophrenia in the occasion of a

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presentation to the German Psychiatric Association in 1908 (Maatz and Hoff 2014). According
to some, such as Minkowski, Bleuler’s work was original and innovating. For others, such as
Gruhle, Bleuler should hardly be mentioned (Berrios 2011), since clear cases of dementia
praecox or schizophrenia had already been described long before Bleuler’s first introduction of
the concept. Kraepelin is supposed to be the true discoverer, and Bleuler would not have done
much more than reshape Kraepelin’s work to make schizophrenia a bit more psychologically
accessible (Berrios 2011, 1096). Whatever position one wants to take in this debate, this last
critique does make sense in a certain way. Bleuler was clearly interested in the psychogenesis of
psychopathology (Maatz and Hoff 2014). His early curiosity led him to work with Freud and
Jung, and, although he himself was not a psycho-analytic psychopathologist, this does illustrate
his tendency towards psychological conceptualization (Berrios 2011, 1096).69
According to Bleuler, ‘schizophrenia’ literally means to illustrate the splitting up of the
mind, or more specifically the dynamic splitting of certain parts or functions of the mind. It is
taken to refer to a “temporary ego/self disorder” (Scharfetter 2001, 36). Contrary to Bleuler’s
intentions, the term became part of a descriptive-nosographical system of mental disorders where
the rigorous description of the symptoms was more important than the supposed pathogenesis.
The latter was generally taken as important at the time, and the reader should recall that in the
beginning of the twentieth century psychodynamic theories had gained considerable scientific
weight. New concepts such as ‘dissociation’ reveal a great interest in psychological clarification.
Bleuler maintains that schizophrenia was triggered or produced by biographical, situational, and
exogenous events. He describes schizophrenic patients as vulnerable, and predisposed for
breakdown by different factors including biological, psychological, and social ones (Scharfetter
2001).
Although they share many basic ideas, Bleuler does not follow Kraepelin on a few key
points. His idea of schizophrenia is not based on the prognosis towards an end-state of debility,
nor by the supposed common factor of early onset. Regarding the progression, Bleuler is more
optimistic (Bleuler 1955, 364-365). He furthermore denies the assumption that schizophrenia is a
disease of the brain (Bleuler 1955, 369). He rather claims — while still reflecting Kraepelin’s
influence — that schizophrenia involves a splitting of cognition, affection, and will, and a
dissolving of the subjective feeling of the personality.

69
Bleuler introduced a new way of thinking about mental illness. Early on in his career he agreed with
Kraepelin’s main assumptions on dementia praecox, only to deny the early onset and the almost inevitable
deterioration (Bleuler 1955; Scharfetter 2001). The idea of the destruction of the inner coherence advocated by
Kraepelin mirrors Bleuler’s ideas of a disruption and splitting of the psychic functions (Scharfetter 2001).

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 The ‘four A’s’ or the fundamental symptoms of schizophrenia
Bleuler can also be credited for distinguishing between fundamental and accessory
symptoms. The fundamental symptoms are often referred to as the ‘four A’s’: affect (flat or
inappropriate), associations, ambivalence, and autism. It has been argued, however, that the
“four A’s” is a simplistic misconception of Bleuler’s work. A detailed discussion is therefore
required in order to suitably understand his ideas on schizophrenia (Moskowitz and Heim 2011,
475).
The first fundamental symptoms listed concern cognition. Bleuler describes associational
thinking, lack of coherence in thought, and disturbances in logic making the patient’s thought
process utterly incomprehensible (Bleuler 1955, 332). One illustration of symptoms affecting
cognition runs as follows: when asked why he does not work, a patient replies that he does not
speak French. Bleuler notices linguistic disturbances, such as ‘Begriffsverdichtung’ and
‘Begriffsverschiebung’ (condensing and shifting of notions). Words are used idiosyncratically
and with no reference to what others could understand (Bleuler 1955, 333). The cognitive
process itself seems deprived of direction or goal, and it falls prey to random associations
(Bleuler 1955, 334). Bleuler also describes formal thought disorders like thought blocking and
flight of thoughts, and adds that these formal thought disturbances are guided by affects. One
second group of foundational symptoms involve affectivity. In fact, Bleuler calls it affective
deterioration (affektive Verblödung), and claims it to be characterized by apathy: “In psychiatric
hospitals the patients just sit around, without having shown any kind of affect over the past
decades, whatever they should encounter in their surroundings” (Bleuler 1955, 334, 336).
However, certain patients also show a different form of affective disturbance, in that they seem
excessively affected. It would not be fair to argue, though, that the general disturbance in
affectivity is reduced to a matter of either too much or too less. It is rather taken as a disturbance
of affect regulation and modulation. It is indeed given most attention whenever affection
becomes rigid, or whenever affections seem unnatural, excessive, or misleading. Interestingly for
the purposes of this research, this affective modulation is taken to directly involve interpersonal
relations, inasmuch as the disturbed regulation of affects is actually a disturbed affective
attunement to others. The schizophrenic patient may even be affectively inaccessible. As Bleuler
writes: “One calls it a ‘disturbance of the affective connection’, which is an important sign of
schizophrenia. One can often feel much more connected with an idiot, who does not speak a
word, than with a schizophrenic person, who might still have his intelligence, but is affectively
inaccessible” (Bleuler 1955, 377).

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 The third fundamental symptom is ambivalence, which was also described by Kraepelin.
Bleuler claims that the main reason for such an ambivalence is the splitting (Spaltung) of psychic
functions.
Finally, the last fundamental symptom is autism. However, this symptom has no
connection to the developmental disorder now known under the same name. Autism meant for
Bleuler a loss of reality and it involves a turning into one’s own phantasy world: “They live in an
imagined world of wish fulfilment and persecution ideas. But both worlds can be real to the
patients: sometimes both are consciously distinguished. In other cases the autistic world is the
only real world, while the other world is fake” (Bleuler 1955, 338). At times one of the two
worlds comes to the foreground, and some patients are capable of interchanging the world they
experience. Less severe cases remain within the shared reality, while more severe cases greatly
indulge in their autistic world, and the other reality may be experienced as a façade, with other
people as mere masks.
Bleuler understands the ‘four A’s’ as part of a disturbance of the personality. 70 His account
does not draw parallels with temporary experiences of depersonalisation, such as those recorded
in certain forms of depression or during panic attacks, but he rather refers to a proper alteration
of ‘the person’. In patients’ experiences the boundaries of one’s own person and body can
become permeable, and objects or others may seem to become part of one’s self. “The patient
may not only confuse himself with any person, but he might identify himself with a chair or with
a stick” (Bleuler 1955, 339). This phenomenon is known as transitivism (Fuchs 2010a, 565).
Since it is sometimes the case that the external world knows or experiences what is most intimate
or personal to the patient, he or she might expect that others can also hear their thoughts. The
sharp border between inner and outer, between the patient and the world of others appears to be
disrupted.

Accessory symptoms
Besides the fundamental disturbances of schizophrenia, also accessory symptoms have
been described by Bleuler. These include sensory disturbances such as hallucinations. Bleuler
notably describes a variety of ‘bodily hallucinations’: the patient feels burning, pain, touching,
streaming in his body (Bleuler 1955, 342). The reactions to these hallucinations are varied, from
ignoring them, or making them meaningful, to full blown aggressive reactions (Bleuler 1955,

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Bleuler’s concept of personality has not the same reference as Husserl’s, as the reader can see in Chapter 2.
Personality in this context means the totality of self-experience, however this point was not further clarified. For
Husserl personality meant, instead, the person as involved in the social sphere.

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343). Bleuler considered delusions to be accessory as well. The main defining criterion for
delusions, according to him, is their lack of logic and their inconsistency and incoherence. These
inconsistencies seem to be fully ignored by the patients. Bleuler furthermore claims that
affectivity plays an important role in the genesis of delusions. Until today, this point remains
open to debate (Spitzer 1992; Ratcliffe 2008; Kiran and Chaudhury 2009). It seems clear that
affectivity is involved in different ways in delusions, however it is unclear whether causal
relations should be postulated from affection to delusion, especially in schizophrenia. Bleuler
himself is persuaded that affections are the key to understand delusions: “The patient wants to be
more than he is; this becomes a delusion of grandeur. Their wishes cannot be fulfilled, but they
do not want to be to blame; a delusion of persecution follows” (Bleuler 1955, 343). On the
whole, according to Bleuler, most delusions in schizophrenia involve some kind of self-
reference, that means, the patient is the centre and goal of the assumed intentions or events.
Although some patients might be aware of the incorrectness of their delusion, they will hold on
tight to it. The famous phenomenon of ‘double book-keeping’ involves exactly this double
orientation to the delusional truth and the normal reality, with a particular inadequacy towards
the content of delusion: “The emperor and the pope help to work on the fields; the queen of
heaven irons the patients shirts and besmears herself and the table with saliva” (Bleuler 1955,
344).
Other accessory disturbances concern language, the failure of which is described in the
following terms: “The most important reason for persisting mutism is that the patient has lost
contact with the outside world” (Bleuler 1955, 345). Bleuler thus interprets mutism as well as
other language disorders as a disconnection from the world and from the others (Bleuler 1955,
345).
To conclude, Bleuler understands schizophrenia as a disorder of cognition, affection, and
subjective experiential life, all relating to an alteration in the personality, or in what one would
call the self (Bleuler 1955, 354-355). The subjective experience of new, strange cognitive
processes and a peculiar co-existence of different affections heighten the feeling of alienation
and, as Bleuler wrote, “it is no wonder that people experience this alienation as strange, unreal,
forced, or automatic” (Bleuler 1955, 355). A loss of the Ego-feeling, of being a person, can on its
turn “influence the normal process of thinking, deform the normal will and disturb the harmony
of affection” (Bleuler 1955, 355). The reader might recall that, in the description of the
phenomenological psychopathology of the self disorder, we already encountered a similar
mechanism involving hyperreflexivity (Fuchs 2010b).

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 The intersubjective dimensions
The first intersubjective element included by Bleuler’s accounts involves the problem of
comprehensibility. On the whole Bleuler shows to be confident about the positive potential of
psychology with respect to schizophrenia. 71 Although Bleuler describes patients’ behaviour
similarly to Kraepelin during his first days at the asylum of Munich, this does not mean that he
considers these patients to be incomprehensible. According to him, even those who manifest
extreme deviant behaviour can be understood when one attempts an empathic approach (Bleuler
1955, 339). The key issue of incomprehensibility is to be discussed in more detail in the second
part of this chapter. For the time being, it is worth noticing Bleuler’s tendency towards
psychogenetic understanding as implying that there is no insurmountable gap between the
clinician and the schizophrenic patient.
Secondly, it has been made clear that a disturbance of affective modulation is taken to be
one of the fundamental symptoms. The rigidity and the unnatural impression recorded by the
clinician leads to a classification of affection as deregulated in one specific way: it is not attuned
to the surrounding and to others. “The joy of a schizophrenic patient does not make us joyful, his
expressions of pain leave us indifferent. In the same way the patients do not react to our own
affects. One calls it a “disturbance of the affective connection”, which is an important sign of
schizophrenia” (Bleuler 1955, 337). Despite all the psychological explanation contributing to the
clinical understanding of patients the clinician may thus still experience a lack of affective
resonance with them.
Thirdly, Bleuler indicates that schizophrenic patients have difficulties preserving the
boundaries of their personalities, as it is clear in transitivism. Whenever patients think that their
thoughts are perceivable by others, it is clear that not only the boundaries of their own
personality or of their subjective experience are blurred but also the boundaries applying to
others. Furthermore some peculiar disruption of the intersubjective world can be postulated.
Schizophrenic autism and double book-keeping show how patients can take a position where the
imagined reality is experienced as separate from the intersubjectively shared reality, but provided
with the same characteristic of realness. The shared reality, conversely, as populated by other
people and their meanings and beliefs of what reality is, might become less real or even a façade,
with other people taken as mere imposters or simply made up characters (Bleuler 1955, 338).

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Karl Jaspers appreciated Bleuler’s acknowledgment of psychology. After Kraepelin, who seemed to have only
little attention for the psyche of the patients he described, Bleuler is welcomed in the following way: “At last
there is some psychological thinking” (Hoenig 1983, 550).

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 The last intersubjective element in Bleuler’s descriptions concerns language. Neologisms
and mutism can be understood as attempts to express what the patient experiences, in a language
that is not commonly shared. But it is equally correct to conclude that these language disorders
indicate that the basis of communication is disturbed. Later on, while discussing Chris Frith’s
contemporary cognitive neuropsychological approach, it will become clear why these language
disorders are particularly intersubjective.

3.1.3 Jaspers
The introduction of philosophy
Karl Jaspers (1883-1969) was the founder and most influential figure of phenomenological
psychopathology. In order to understand his view on schizophrenia, some of his philosophical
and psychopathological concepts need to be elucidated here. Although Jaspers and Bleuler hold
distinct ideas on psychopathology, both of them can be said to give primacy to the ‘psyche’ of
psychiatry: “The task of phenomenology is to represent the psychic states as the patient really
experiences them, to search for the relationships between them, to delineate them as much as
possible, to distinguish them from each other, and to name them with correct terms” (Jaspers
1948, 48). In 1913, when he was only 29 years old, Jaspers published his General
Psychopathology. At the time psychopathology was dominated by the fast growing influence of
neuropathology on the one hand, and by psycho-analytical theories on the other (Monti 2013, 30-
31). The young Jaspers attempted to bring clarity into the chaos of nosology and
psychopathology. His personal approach to this field was rigorous description, definition, and
classification, in order to make psychopathology a real science, with valid and reliable methods.
Whether or not Jaspers really is a phenomenological psychopathologist himself remains
open to debate (Berrios 1992; Walker 2013; Wiggins and Schwartz 2013), however it seems
clear that with his General Psychopathology and particularly with his interest in the
methodology of psychopathology, he secured an important position to phenomenology.
Phenomenology in psychopathology should be preliminarily distinguished from phenomenology
as a philosophical field. Both disciplines share their interest in the phenomena as experienced by
the subject, and in order to grasp these phenomena, they both maintain that one needs to perform
a reduction or an ‘epoché’, as to set aside all personal assumptions, theories, and certainties (Sass
2013b, 99; Rinofner-Kreidl 2013). Only by doing this will one be able to describe the
phenomena as they present themselves. However, in psychopathology and especially in clinical

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encounters, the target of the description differs from one’s own experience, rather embracing the
experience of the patient.72
The General Psychopathology is not just an overview of the different psychopathologies of
the time. It is also an exploration of the methods and ways of psychopathology, and the
knowledge it could provide. Phenomenology does have an important place in it, but it is not the
only method envisaged. One of the most interesting elements in the book includes the famous
distinction between understanding (Verstehen) and explaining (Erklären) (Jaspers 1948, 24).
This was inspired by Wilhelm Dilthey (Jaspers 1948, 250) and his earlier distinction between
‘Naturwissenschaft’ and ‘Geisteswissenschaft’ (Jaspers 1948, 642). Although both explaining
and understanding have their role to play in psychopathology, and although both offer scientific
evidence, Jaspers claims that they should be strictly kept apart (Jaspers 1948, 24). Explanation is
required for the acknowledgement of causality and objective connections. It implies a
perspective from the outside and makes use of empirical methods. The earlier mentioned
dopamine hypothesis would be a form of explanation, according to Jaspers’ distinction.
Understanding, on the contrary, is defined as a perception (Anschauung) or a representation
(Vergegenwärtigung) of the psychic phenomena from the inside (Jaspers 1948, 23-24).73
Within understanding, Jaspers distinguishes two further forms. First, there is a direct
empathic grasping of the patient’s psychic state and conscious phenomena, which he calls static
understanding. Based on the verbal and non-verbal expressions and the behaviour of someone, I
am able to immediately grasp his or her psychic state, for example sadness.. Secondly, there is a
form of understanding from the inside concerning how mental states emerge from each other,
and how they are meaningfully connected, which he calls genetic understanding. I understand,
for example, how someone’s anger follows from frustration. It is worth remarking that Jaspers’
phenomenology is essentially static understanding.
The limits of static understanding, and thus of phenomenology, are reached when dealing
with what is not conscious (Jaspers 1948, 16), as well as with the somatic (Jaspers 1948, 48).

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Another point of discussion concerns the exact influence of Husserl on Jaspers’ theories. The methodological
problems and solutions discussed by Jaspers are arguably influenced by the early Husserl (Blankenburg 1991a;
Sass 2013b, 99-100). Jaspers does refer to Husserl explicitly (Jaspers 1968), however he expresses criticisms of
the eidetic turn in phenomenology. Nevertheless, one can find a similar approach in the phenomenological
psychopathology he developed. A well-described case is indeed taken to provide psychopathological insights,
which are useful for all other cases. The essences of a disorder are taken to be retrievable in the idiosyncratic and
subjective experiences of a patient. “The particular, and not a massive plurality of cases, is the most elucidating
for psychology, and the condition to clarifying the plurality of trivial cases in the first place” (Jaspers 1948, 11).
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This methodological distinction will be relevant for the discussion of delusions in section 3.2.2. It is worth
noting that Husserl’s account of empathy does not unconditionally accept the representation of the other’s inner
life, as Jaspers seems to do in order to understand the patient. Husserl (1973a, 374) writes, for instance: “It is
questionable, whether an I can represent the experience of the other and thereby come to some form of
knowledge”.

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Limitations are also displayed by particular experiences that the clinician cannot understand
through empathy (Jaspers 1948, 486). In those cases, the gap between the clinician and the
patient is supposed to be just too wide, and the former cannot participate in the reality of the
latter (Sass 2013a, 98-99). Jaspers considers certain psychotic phenomena, and particularly the
‘primary delusional experience’ as prototypes of incomprehensibility (Jaspers 1948, 82, 483-
486). Although he does not conceive incomprehensibility as an a priori for every clinical
encounter with delusional patients, his claim is often understood in this way (Henriksen 2013;
Spitzer 1989, 30). He does indeed remark that schizophrenic life in general, and not only certain
delusional phenomena, is in essence incomprehensible to us (Jaspers 1948, 486). Jaspers
concluded that, in these cases, understanding falls short, and explanation is needed (Jaspers
1948, 253). A lot of contemporary perspectives on psychopathology de facto follow Jaspers on
the limits of understanding and the need for explanation.
Nevertheless, the problem of explanation in psychopathology concerns the validity of the
explanations, or in other words, the relation of explanans to explanandum. How do we know that
our hypotheses and theories have anything to do with the patient’s experiences once we assume
the incomprehensibility of these experiences? The assumption of incomprehensibility implies
that we may lose the actual phenomenal experience of the patient out of sight. The distinction of
understanding and explaining is still often used as an argument in psychopathology, but it seems
that such a clear-cut distinction, as Jaspers outlined it, is too rigid. It is easy to claim that there is
already a part of explanation in understanding, and some understanding in every explanation.
“‘Causes’ and ‘meanings’ (as that which is explainable and as that which is understandable) are
only comprehensible when taken in constant interplay with each other” (Fuchs 2014a, 83).74

Delusions and incomprehensibility

As anticipated, the theory of the alleged incomprehensibility of schizophrenia is clearly
very important. Jaspers claims that schizophrenia is not empathically, thus not directly
understandable, but a certain form of explanation from the outside is required in order to grasp it
(Jaspers 1948, 484, 486). The origin of the incomprehensibility are the ‘real delusions’, which

74
If Bleuler introduced psychological thinking into psychiatry, it was Jaspers who introduced philosophical
thinking, as is shown in his analysis of the ‘brain mythologies’ and the problem of mind-body dualism (Jaspers
1948, 381-382; Fuchs 2014a, 82). According to Jaspers, philosophy is necessary in psychopathology inasmuch
as 1. it makes us aware of both our implicit theoretical assumptions and of the limits of certain methods, 2. it
compels us to maintain a holistic approach, 3. it makes us appreciate different kinds of understanding, 4. it helps
us understand the metaphysical and existential dimensions in psychopathology, and 5. it offers a distinct
approach to the human condition other than the pure scientific knowledge (Jaspers 1948, 643). Philosophy gives
us the necessary openness for doubt and uncertainty. Ignoring our doubts and the uncertainty of our scientific
attitude, is not a scientific attitude itself (Jaspers 1948, 644).

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originate from the ‘primary delusional experience’ (Jaspers 1948, 80). Real delusions supposedly
have to be distinguished from delusion-like experiences (wahnhafte Erfahrungen). Jaspers
claims that we cannot empathically grasp the primary delusion experience, nor do we understand
genetically where it emerges from. Both chronologically and ontologically, this experience
precedes any further elaboration or crystallization (depending on whether one conceives of this
as an active or passive process) of the delusional world (Kusters 2014, 605). Patients notice a
sudden change, which perplexes them, but they cannot explain it: "Something is happening,
please tell me what it is” (Jaspers 1948, 82). This moment is often called uncanny, or in the
German original ‘unheimlich’ (Jaspers 1948, 73, 346). It is still discussed today whether this
incomprehensibility is restricted to the origin of the schizophrenic delusion, namely the primary
delusional experience, or whether it concerns the whole of the schizophrenic life, as Jaspers
tends to indicate.
Jaspers characterizes delusions by three epistemic features: absolute certainty,
incorrigibility, and the lack of concordance with reality. However, he remarks that delusions
should be the object of phenomenological study, rather than of epistemic description. While
Kraepelin and Bleuler point to the peculiar co-existence of seemingly excluding realities or
worlds, namely of the shared and the delusional world, Jaspers adds that ‘double book-keeping’
often changes in time and it may well seem that patients lose their delusional convictions
(Jaspers 1948, 351). He does not go as far as identifying this loss of delusional conviction as
‘regained insight’, since he believes a closer examination would mostly show patients still
holding on to their delusional convictions (Jaspers 1948, 248).75

Schizophrenia
After Kraepelin’s and Bleuler’s groundwork listing the symptoms of schizophrenia,
Jaspers investigates what is ‘behind’ these symptoms (Jaspers 1948, 471). He believes the
answer to be a disturbance of the ‘I’, of the ‘Ego’, or of the ‘personality’. Schizophrenia, he
claims, concerns a disorder of the ego-consciousness (Ich-Bewusstsein). He then distinguishes
four specific disturbances of the ego-consciousness.
The first affects the consciousness of the activity of the ego. This latter is further divided in
the awareness of existence or of being-there (Daseinsbewusstsein) and in the awareness of

75
Contrary to psychoanalytical theories, Jaspers explained that too much attention for the content of the delusion
leads to unscientific speculation: “A lot of things have been claimed to be comprehensible, which are not
comprehensible at all” (Jaspers 1948, 340). Bleuler’s and Jung’s attempts were based on the model of hysteria,
which, according to Jaspers, has little to do with schizophrenia (Jaspers 1948, 431).

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agency (Vollzugsbewusstsein). The disturbance of the awareness of agency is then connected to
thought insertions and passivity experiences (Jaspers 1948, 102).
The second disturbance involves the unity of our self-experience. The resulting disunity
can be compared to situations of higher and distanced self-reflection, such as when you perceive
yourself talking to people, and consequentially fail to talk fluently. The unity of the person
talking, and of the person perceiving him or herself talk, seems to be lost for a moment (Jaspers
1948, 104).
The third element of the ego disturbance in schizophrenia concerns the ego’s temporal
continuity. Some patients claim, for instance, that they are not the same persons as before the
outbreak of their illness (Jaspers 1948, 105).
The fourth element affects the consciousness of the demarcation between the ego and the
outside world (Jaspers 1948, 101). Patients claim for example that they do not have to answer
any questions, because the psychiatrist already knows everything they are thinking (Jaspers
1948, 106). Another example of a disturbance of this fourth element is the patients’ self-
identification with objects of the outside world, as already mentioned concerning Bleuler’s
description of transitivism.
Throughout different versions of the General Pathology these four elements have changed,
possibly under the influence of Kurt Schneider. This influence is most noticeable with regard to
the introduction of a new element in the form of a disturbance of the self-other difference, which
leads to the experiences of permeability. Permeability then became the hallmark of the ego-
disorders (Fuchs 2013c, 247). These, and similar experiences are taken to lie at the heart of the
primary delusional experience, which is arguably the origin of real delusions and at the same
time the reason for the schizophrenic incomprehensibility. Jaspers himself was possibly inspired
by Austrian psychiatrist, Joseph Berze who described a similar disorder of the psychic activity
and called it hypophrenia (Fuchs 2013c, 247). Other psychopathologists have worked further on
these ideas, among others Huber and Klosterkötter. As previously argued in the introduction to
this research, this has greatly inspired the contemporary phenomenological approach envisaging
schizophrenia as a self-disorder (Fuchs 2015a).
Contrary to Kraepelin, Jaspers describes the chronic phase of schizophrenia as the
consequence of a general alteration of the Ego, rather than as a cognitive deterioration (Jaspers
1948, 185). This phase is characterized by the loss of feeling for the essential, the communal,
and the real. While quoting French psychiatrist Minkowski’s work, Jaspers writes that this
indeed indicates a loss of contact with reality (Jaspers 1948, 185). According to him, it is not
cognitive deterioration what different patients share, but rather incomprehensibility. He describes

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the schizophrenic patient as “incomprehensible, alien, cold, inaccessible, rigid, stiff”, and “facing
these people you feel an indescribable abyss” (Jaspers 1948, 373).
Besides the general disturbance of the Ego-consciousness and incomprehensibility, Jaspers
also describes alterations in temporal experience (Jaspers 1948, 72). He furthermore notices
alterations in the use of language and refers to it as the building up of private languages (Jaspers
1948, 243).76

Incomprehensibility: a problem of intersubjectivity

The intersubjective dimension of schizophrenia is explicitly accounted by Jaspers’
descriptions of the disorders of the Ego in the specific terms of experiences of permeability and
passivity. Nevertheless, his claims on incomprehensibility are the most intriguing.
Incomprehensibility is a unique topic thread in his work. Compared to Kraepelin’s and Bleuler’s
descriptions of the lack of affective connection, Jaspers goes a step further. Due to Jaspers’
interest in phenomenology, and in the psyche of psychiatry, he is able to acknowledge
incomprehensibility as such as the most frustrating and significant element in schizophrenia. As
previously mentioned, incomprehensibility is, for Jaspers, both a philosophical and
methodological problem. The primary delusional experience resist any understanding; similarly
what it is like to experience a delusion of passivity cannot be statically understood. However,
how an elaborated delusion follows from a primary delusional experience can be genetically
understood. This does not imply full understanding of the delusion, as its origin is
incomprehensible. Therefore, external explanations and knowledge have to be employed here.
Jaspers even characterizes schizophrenic patients in general as incomprehensible (Jaspers 1948,
373, 486), and their private languages are a good example in this regard. Some
phenomenologists have criticized this idea and different phenomenological attempts have been
made to overcome incomprehensibility (Ratcliffe 2012; Henriksen 2013; Stanghellini 2013; Van
Duppen 2015).
Yet, incomprehensibility appears not to be a merely philosophical and methodological
problem concerning the accessibility of the patient’s mental life. Incomprehensibility also ensues
from the peculiar experience one can have in the encounter with certain schizophrenic patients.
In these cases, it seems to fall within the range of ‘praecox feeling’ (Rümke 1960) rather than

76
He furthermore described a dialectical psychopathology of schizophrenia. Normally, different tendencies in
our psychic life balance each other. Automatism, echolalia, and echopraxia illustrate that in schizophrenia this
balancing system is disturbed. The different tendencies lose their normal harmony and Bleuler’s ambivalence
then emerges (Jaspers 1948, 286).

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within that of philosophical scepticism and ‘the problem of other minds’. Incomprehensibility
would then be an issue of affective attunement to others, rather than of our knowledge of the
other’s perspective. I will discuss this in more detail in section 3.2.1.
Jaspers describes the loss of feeling for the communal and, as previously mentioned, he
refers to Minkowski’s ‘loss of vital contact with reality’. I maintain that this disruption of the
normative communal feeling is secondary, both in importance and in specificity, for
schizophrenia. It will become clear further on that the hypothesis of a prior alteration of
intersubjectivity is able to account for the direct implication of such disruptions of the
communal. It should furthermore be clear that incomprehensibility should not be accepted as
radical based on naïve clinical experience or on the one-sided interpretation of Jaspers. Jaspers
himself is much more cautious than that, as Stanghellini explains: “Instead of falling prey to
scepticism, or of an impersonal and metaphysical knowledge of the other, Jaspers exhorts
clinicians to navigate the infinite space that separates them from their patients” (Stanghellini
2013, 180).

3.1.4 Minkowski
The loss of vital contact with reality
Eugène Minkowski (1885-1972) was a French psychiatrist born in a Jewish Polish family
in St-Petersburg. He studied medicine in Poland, Germany, and Russia, and afterwards
philosophy in Munich. Although his influence on phenomenological psychiatry has been
significant, he never had the opportunity to work in an academic hospital, nor to teach
psychopathology. Philosophically he was inspired by Henri Bergson and to a lesser degree by
Edmund Husserl. Minkowski thought that the scientific methodology of early phenomenology
was missing something of Bergson’s existential vitality (Minkowski 1966, 457). The ultimate
goal of phenomenological psychopathology, according to Minkowski, should be finding the
‘trouble générateur’ (Minkowski 1966, 53) of an illness, by ‘penetrating’ (Minkowski 1966,
461) through the superficial symptoms.
Today Minkowski is often quoted in phenomenological psychiatry as one of the fathers of
the psychopathology of the self (Bovet and Parnas 1993, 582; Sass and Parnas 2001, 103;
Cermolacce et al. 2007, 712; Fuchs and Schlimme 2009, 82; Sass 2014, 2). His notion of ‘the
loss of vital contact with reality’ has become very well known. However, the exact meaning and
the relevance of this notion for the intersubjective dimension of schizophrenia seems often to go

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unacknowledged.77 ‘The loss of vital contact with reality’ is arguably the most central notion in
his work and it is often used to elucidate certain symptoms and experiences of schizophrenic
patients. Schwartz et al. (2005, 110) understand it as the destruction of the ‘manifestness and
coherence’ of the person’s ‘being-in-the-world’. Sass compares it to patients’ experiences of
progressive dulling of their subjective lives (Sass 2001, 255).
In one of his first noteworthy articles, Minkowski summarizes Eugen Bleuler’s ideas on
schizophrenia for the French readers of ‘l’Encéphale’ (Minkowski 1921).78 It is in this article
that Minkowski uses the notion of ‘loss of vital contact with reality’ for the first time. The notion
aims at unifying Bleuler’s pathognomonic symptoms and signs of schizophrenia (Minkowski
1921, 248). The described symptoms are taken as generally resulting from the loss of vital
contact with reality, which he conceives as the starting point of the illness (Minkowski 1927,
198). Later on in Minkowski’s works, the same notion acquires different meanings, and it
becomes somewhat of an ambiguous notion with no longer any connection to Bleuler. It is now
worth analysing the concept into its three major building blocks: ‘reality’, ‘contact with reality’,
and ‘vital contact’.79

Reality: language, rules, praxis

Reality is expressed and experienced in different domains. Language is the first of these.
The role of language for the experience of reality is described ex negativo: in schizophrenic
autism, a patient might speak “his own language” (Minkowski 1927, 149). The creation of a
new, private language goes hand in hand with the destruction of reality. Symbols and
significances may become strange or unrecognisable. A disturbance of reality leads to the
dysfunction of symbols and language in general (Minkowski 1921, 317). Both logorrhea (salade
des mots) and mutism can characterize the disconnection from reality (Minkowski 1921, 254).
The earliest therapeutic goal, according to Minkowski (1966, 41), should therefore be finding a
common language with the patient, in order to bring the psychotic patient back into a shared
reality.

77
A variety of phenomenological authors have written on Minkowski’s ideas in more detail. Several key
concepts in the contemporary literature refer directly to his work, for example ‘schizophrenic autism’ (Parnas
and Bovet 1991), ‘morbid rationality’ (Sass 2001), and ‘phenomenological compensation’ (Urfer 2001).
78
Bleuler was of great importance to Minkowski, especially during the time he worked under his supervision in
the Burghölzli clinic in Zürich. According to Minkowski (1927, 256-257), Bleuler’s redefinition of ‘dementia
praecox’ as ‘schizophrenia’ had a remarkable impact on psychiatry. Firstly, as the reader already knows, the
emphasis on an underlying cognitive deterioration was minimized. Secondly, new therapeutic hope arose for
schizophrenic patients. Minkowski favoured these changes, and he continued to elaborate the work of his
predecessor throughout his career.
79
An extended version of this subsection on Minkowski will be published as (Van Duppen forthcoming).

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 The second domain of reality concerns rules:
“We find the same phenomenon of vital contact with reality in the feeling of measure and
limits which surrounds all of our precepts like a living fringe in rendering them infinitely
nuanced and infinitely human” (Minkowski 1970, 69). We sense the measure of things and the
limits of the possibilities of our actions even before the precepts are made explicit. The ‘vital
contact with reality’ is then related to the sense of measure we sense towards each other’s
actions. Actions that are within the limits, or within good measure, are thought of as ‘realistic’,
in contrast to the ‘autistic’ actions of schizophrenia (Minkowski 1927, 147; Urfer 2001).
Furthermore, reality is said not to only depend on the explicit rules of conduct, but also on
unwritten rules, and our implicit sense of them. In this regard, the attitude of stagnant
overthinking and over-structuring of situations, that Minkowski calls ‘morbid rationalism’, is
taken not as a cognitive deficit per se, but rather as the expression of the loss of reality
(Minkowski 1995, 260-261).80 Rules, and particularly our use of them, are taken to define what
is in accordance with reality, and what is not. However, our application and following of these
rules is taken to happen dynamically.
This also leads to the third domain of reality, which is closely related to both language and
rules, namely praxis. The term ‘praxis’ indicates here the practical involvement of a person in his
or her surrounding world. In this regard, it is a common feature of schizophrenic patients to
struggle to adequately use certain knowledge (Minkowski 1927, 559). Again, according to
Minkowski, it is not the cognitive part of an activity that fails, but rather the patient’s use or
implementation of this knowledge. This practical knowledge and the lack thereof are illustrated
by Minkowski as follows: if someone’s house was at the edge of being flooded with water,
formally it would be correct to state that a certain volume of H20 and salts was flowing at a
certain discharge. But, of course, such judgment would testify for an absence of pragmatic and
contextual reasoning when failing to act accordingly (Minkowski 1921, 254).

Reality: contingency, irrationality, ambiance

Besides language, rules, and praxis, three other elements can be added to Minkowski’s
concept of reality. The first is contingency. It is indeed claimed that as soon as someone loses the
awareness of the contingency of their everyday experience of the world they partake in, they will

80
‘Morbid rationalism’ or ‘morbid geometrism’ are the terms Minkowski uses to describe some patients’
pseudo-scientific attitudes in their own emotional and everyday life, when static and rigid thinking replaces
dynamic and fluent interactions. One patient, for example, contemplates his encounter with an attractive woman
during hours of motionless silence on a chair. He concluded that “everything in life, even sexual sensations, is
reducible to mathematics” (Passie 1995, 261). The rigidity and over-rationalising of this act is considered beyond
reality (en dehors de la réalité) (Minkowski 1966, 156).

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lose contact with reality. “We are quite able to feel a pricking or see a spark without relating
these phenomena to a conversation that we are able to hear at the same time. We very well
conceive of isolated facts and objects whose simultaneous coexistence may be purely
contingent” (Minkowski 1970, 425). For a schizophrenic patient, this coexistence may not be so
unproblematic, and “a mysterious force” (Minkowski 1995, 390) might seem hidden behind the
phenomena. The overwhelming presence of meanings and associations that all seem to point at
the patient may lead to an attitude of withdrawal and avoidance (Minkowski 1966, 644). Reality,
as Minkowski would describe it, thus requires an attitude of the subject towards the world that is
characterized by contingency, rather than by the subject’s own centrality.
Secondly, Minkowski’s reality has to be distinguished from rationality. Although praxis
and rules clearly play a role in Minkowski’s concept of reality, this does not mean that these are
entirely rational (Minkowski 1926, 555). Arguably, if we were to approach every aspect of
reality through rationality, we would exclude an essential part of it. Minkowski indeed refers to
our capacity to imagine the world around us, and to co-constitute it together with others and their
imagination (Minkowski 1966, 549). “[Imagination] lays a light veil on the hard reality, in its
materialistic sense. By covering it and penetrating in all of its parts, [imagination] softens it,
makes it lighter, less concrete, but not less real than before” (Minkowski 1966, 550).
The third notion is that of ‘ambiance’ (Minkowski 1966, 75). Minkowski’s reality is not
just the material world that is external to us. Lived reality, rather, is what we experience through
our contact with the ambiance. In this surrounding world, the distinctions between object and
subject, or between inside and outside, fully dissolve.81 The inner world of a person is taken to
be just as real as the outer world. However, this does not mean that ambiance is restricted to one
sole individual or to each individual separately. Rather, what is relevant for reality is common
ambiance (Minkowski 1966, 107). To conclude, the first building block, namely the concept of
reality, is expressed and experienced in language, rules, and praxis. Moreover, the coexistence of
rationality and irrationality makes reality a lived reality, which we experience as partly
contingent. Finally, Minkowski’s reality is a common ambiance where our activities are
meaningful to others.

81
The German word ‘Umwelt’ as introduced by von Uexküll (1909) might fit the description better than
ambiance. As it has been argued in Chapter 2, both Husserl and Merleau-Ponty discussed the surrounding world.
Minkowski’s understanding of it is comparable to Merleau-Ponty’s theory.

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 Contact with reality: time, space, sympathy
The second step concerns the contact with reality. According to Minkowski, there are three
modes of contact with reality. The first concerns time. Following Bergson’s distinction between
objective and subjective or lived time (Bergson 1970), Minkowski states that our experiences are
constantly accompanied by a feeling of moving towards the future, or of becoming (devenir)
(Minkowski 1995, 17). We also share this becoming with the ‘ambiance’. Bergson’s ‘élan vital’
is then the source of a future-oriented bond between the individual and his ambient becoming
(Urfer 2001, 280): “It is not only that we feel a general progression, in us as well as outside us,
but rather a unique rhythm common to us and to ambient becoming that makes me feel that I am
advancing in my life simultaneously with time” (Minkowski 1970, 69-70).
Finally, the ‘vital contact with reality’ is taken to be a form of contact with the ambiance,
through a shared rhythm between the individual and the ambient becoming. Minkowski calls this
‘synchronism’ (Minkowski 1995, 59, 63). Historically, this idea stems from Kretschmer’s
distinction between ‘schizoidia’ and ‘cycloidia’. As is known, Bleuler redefined this distinction
as ‘schizoidia’ Vs ‘syntonia’, insisting on a non-morbid description of the vital principles of life.
Within this framework, ‘schizoidia’ is described as the principle of withdrawal and of returning
to oneself. ‘Syntonia’ refers instead to taking part in social life, and is characterized by openness
towards the world (Minkowski 1966, 534). Rhythm plays, furthermore, an important role in all
this: someone who shares most of their rhythm with their surroundings tends to syntonia, while a
person who has a private rhythm tends to schizoidia (Minkowski 1995, 273, 275). On the whole,
sharing a rhythm stands for the possibility of contact with others (Minkowski 1995, 59). 82
Consequently, in schizophrenia, Minkowski claims, the desynchronisation implies that the
patient does not take part in the collective or ambient becoming any more, and does not resonate
with others (Minkowski 1958, 132, 259).
The second mode of contact with reality concerns space. Parallel to Bergson’s ideas on
time, Minkowski distinguishes measurable or geometrical space, and lived space: “There is a
distance which separates me from life or, rather, which unites me with life. There is always a
free space in front of me in which my activity can develop” (Minkowski 1970, 403). Different
from geometrical space, lived space is defined by the distance to others, and by the distance in
between us. Minkowski sees this distance as dynamic: at times it may separate us, and at times it
may unite. There is a free space in between us, that we experience as an openness of possibilities

82
This is certainly true for affective resonance, as developmental psychology has shown (Beebe et al. 2003;
Stern 1985). The rhythmicity of the interaction, rather than complete congruence, is a necessary requirement for
smooth interpersonal contact (Fuchs 2013d, 81).

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(Minkowski 1995, 374). Free space makes it possible to live, to interact, but allows us to
withdraw in relative isolation as well. According to Minkowski, what Jaspers (1948, 82) calls the
delusional mood (Wahnstimmung) actually concerns disturbances in lived space. The experience
of a “vague resemblance” (Minkowski 1995, 377) is itself a disturbance in experiencing lived
space: objects may seem to point at the patient, people may become threateningly close, the free
space is not experience as such (Lysaker et al. 2005).83
The relation between space and reality is further elaborated in Minkowski’s attempts to
describe a psychopathology of space that deals with hallucinations and delusions. He describes
both as the opening up of a different world, of a different space, on top of the shared world or
space. In order to better clarify this view of two spaces, he distinguishes between the dark and
the light world (Minkowski 1995, 393). The light world is the space where lived distance,
possibility and openness are standing. It is a shared world with others. The patient who is
hallucinating or has delusions may partly remain in this world. However, patients can also find
themselves in the dark world, which is the morbid world with disturbed distance and measure, in
which the patient is completely alone (Minkowski 1995, 394).
Finally, in Minkowski’s account, sympathy is the last mode of contact with reality, albeit a
particular reality. This mode explicitly emphasizes the intersubjective experiencing of reality, the
reality of the immediate other: “I speak here of that marvellous gift which we have in us of
making the joys and pains of our fellow man ours, to penetrate us entirely, to feel ourselves in
perfect communion, to be one with them” (Minkowski 1970, 67). Sympathy shows that our
contact with reality is a shared one: we participate in the reality of each other. Difficulties in
spontaneous interpersonal affective resonance impede instead this very participation. Notably,
during his time in the Burghölzli clinic, Minkowski records an absent or disturbed affective
contact with schizophrenic patients (Minkowski 1921, 255).

Vital contact
The third and last building block concerns the adjective ‘vital’. When Minkowski first
introduces his concept in 1921, he explains that ‘vital’ distinguishes the contact he intended from
the everyday meaning of contact in a spatial sense, such as touching an object (Minkowski 1921,
249). However, from today’s perspective, it is difficult to ignore his later work, and in particular
the influence of Bergson’s theory on the meaning of ‘vital’. In this regard, the adjective also

83
Other examples of this disruption in distance and lived space are provided by (Fuchs 2005b, 134): a patient
reports feeling an “energetic potential” passing over from other persons to his own body and entering through his
forehead. Another patient feels the contours and metallic qualities of cars that he sees passing down in the street
as vivid bodily sensations.

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refers to the ‘élan vital’ (Minkowski 1995, 34-35), this being the continued dynamism that
directs us and our activities towards the future. Furthermore, the same concept can be best
understood, in my opinion, as the conative-affective dimension of our lives, as it is sometimes
described as drive, striving, urge, or affection.84
Finally, the contact with reality is vital, whenever it is characterized by a dynamic shifting
between schizoid and syntonic intentions and activities. Being part of the ambiance, to blend in,
is syntonia. As previously explained, it is the experience of sharing the same frequency, having
the same rhythm as others. However, syntonia is not the only aspect of life, nor is it the only
healthy or normal one. Equally important is the opposite direction: away from the ambiance, in
disharmony with others, towards self-realization: “We do not only want to blend into the
ambiance or have to adapt ourselves to others, we want to affirm our own personality, we want
to exteriorize our most intimate self, we want to leave a personal impression into the moving
wave of change, we want to force ourselves upon the infinite world and produce and create”
(Minkowski 1927, 162). This is the cycle of personal activity. It is the co-existence of two
opposite movements: towards the world and others, and away from them.
Schizophrenic patients may not always be able to cycle dynamically between these two
terrains. Schizophrenic autism is essentially the absence of syntonic possibilities. Minkowski
also recognizes this disturbance of the dynamic cycle in what appear to be empty and
meaningless activities in the eyes of the outside world (Minkowski 1995, 264).

Relevance for intersubjectivity

It should be remarked that Minkowski’s view is generally based on a restricted form of
schizophrenia. Both in his early work, and in later psychopathological descriptions, he tends to
minimize certain symptoms (Minkowski 1966, 95). For some contemporary clinicians, it is
rather surprising that the positive symptoms of schizophrenia, such as hallucination and delusion,
play only an accessory role within Minkowski’s account. In most diagnostic classifications, these
two symptoms are considered important diagnostic criteria (World Health Organization 1993;
American Psychiatric Assocation 2013). Minkowski does not justify his neglect, despite showing
to be well aware of Bleuler’s categorization. Sass rightly notices that symptoms of
disorganization, disturbances of thought, language and attention, as well as Schneider’s first-rank
symptoms are nevertheless hardly mentioned in his work(Sass 2001). It should also be remarked
that, at the time, Minkowski stood relatively alone with this view, as psychopathologists such as

84
On the role of the ‘élan vital’ in our experiential life and its relation to the ‘intentional arc’, see Fuchs’
descriptions (Fuchs 2006; 2013d) on explicit and implicit temporality.

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Karl Jaspers, Ludwig Binswanger, and Kurt Schneider were developing their theories on
delusions, and psychosis in general to great recognition. Despite the emphasis on positive
symptoms in clinical praxis and classifications, contemporary psychopathologists seem
nevertheless to agree with Minkowski’s view that the disturbances of the self are more central, or
closer to the ‘trouble générateur’ (Blankenburg 1971; Sass and Parnas 2003; Nordgaard et al.
2008). All in all, several difficulties or disturbances of intersubjectivity can be found in
Minkowski’s accounts. First, he takes Bleuler’s concept of autism and indicates that it is not a
matter of living in phantasy worlds, but rather a matter of turning away from others. What were
previously recognized as language disturbances are instead taken as private language, related to a
private reality. The patients are said to be unable to follow particular rules of praxis, and they
might seem to miss a sense of rules. This very sense is arguably what makes the use of rules
dynamic, while the schizophrenic patient might be stuck in a rigid or static rationalism. Normal
reality experiences are furthermore taken as depending on our implicit acknowledgement of
contingency, while schizophrenic patients might experience their reality in an ego-centric way.
Although hallucinations and delusions are only taken to be accessory, Minkowski does deal with
them extensively, and his whole concept of schizophrenia is described as a deviation from
reality, of which hallucinations and delusions could be considered perfect examples. He
furthermore describes psychotic phenomena as expressions of “brutal isolation” (Minkowski
1966, 95).
He also describes patients as desynchronized. They do not share the same rhythm and do
not vibrate in resonance with others. The dynamic movement between schizoidia and syntonia,
away from and to others, is clearly disturbed, with schizoidia dominating. With regard to space,
Minkowski identifies a disruption of lived space, of the space created in-between others and
myself. This becomes apparent in delusional moods and threatening phenomena like transitivism
(Minkowski 1966, 15). Lastly, the loss of vital contact with reality can be experienced as a
disturbed or absent affective contact with the patient (Lysaker et al. 2005), as Bleuler argued
before him. In section 3.2.1 Minkowski’s precise description of the disturbance of affective
contact shall be thoroughly investigated. To conclude this section about Minkowski, and about
the intersubjective dimensions of the ‘loss of vital contact with reality’ in schizophrenia, Urfer’s
position (2001, 281) should be mentioned and agreed upon: Minkowski’s phenomenological
approach concerns the intersubjective space of the ‘entre deux’. Minkowski is indeed a
psychopathologist of the in-between.

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3.1.5 Kimura
The psychopathology of the ‘in-between’
Kimura Bin (1931) is a Japanese psychiatrist who completed his specialization in Munich
and Heidelberg, after studying medicine at the university of Kyoto. Upon his return to Japan, he
translated some major works of phenomenological psychiatry, including Minkowski’s book
Schizophrenia. His personal work was then greatly influenced by phenomenological psychiatry,
especially by Blankenburg, and by Japanese philosophers, such as Kitaro Nishida and Tetsuro
Watsuji (Stevens 2003). Kimura clearly relies on Nishida’s work on the self (Stevens 2003, 692),
and borrows Watsuji’s idea of Aidagara, or “what relates to the in-between”, which he owed to
Heidegger’s Mit-sein (Arisaka 2001, 198). Although his work is firmly rooted in Japanese
culture, different European philosophers have inspired Kimura‘s original view on
psychopathology. One could mention here Levinas, Merleau-Ponty, or Heidegger, who all
described a role for the ‘in-between’. However, one of Kimura’s distinctive features is his ability
to expand the phenomenology of psychopathology to the study of a wider cultural context.
Kimura has clearly a unique position in the so far provided list of psychopathologists. Not
only because his cultural background is different, but mostly because he is the first to explicitly
define schizophrenia as a disturbance of intersubjectivity. Despite his originality, his ideas will
have to be read with a certain criticism, especially the conceptual obscurities that could not be
clarified.
The most original idea Kimura brings into psychopathology is that of ‘Aida’, which can be
best translated as ‘in-between’. The in-between is a space or an opening between two poles, for
example between two people. Kimura insists that the in-between plays a role in the constitution
of the poles, and depending on which type of Aida one intends, it constitutes the self or the other.
The first type is the Aida between nature and human, which he calls climate. The second is an
interpersonal Aida. The third is the Aida that emerges in-between aspects of the self. In what
follows these three types will be discussed followed by a thorough account of his ideas on
schizophrenia.

In-between nature and human

Since Kimura is a dialectical thinker, the same structure of a prior union resulting in two
poles is outlined in all three forms of Aida. The first concerns the relation of self and nature. He
claims that before one acquires any knowledge of nature, such as the fact that water is wet, or
that the world is not flat, one is already connected to it. It is this pre-reflective moment that
Kimura is most interested in. It is indeed a moment of unity and it precedes distinction and

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separation. In that moment the self and nature are said to form a whole (Kimura 1995, 62).
Subsequently: “The existence of the self is for this self not self-evident at all. The self originates
continuously out of, and through the real encounter with that, what he himself is not (in this case
nature), in the moment of interruption of this encounter by a reflecting consciousness” (Kimura
1995, 62). The reader might feel here the echo of Husserl’s definition of the I in opposition to
what it is not, the not-I (Husserl 1973a, 244).
As anticipated, the in-between plays a complex role, inasmuch as it is the origin of both the
unity and the distinction of the poles. This unity or wholeness of nature and self is what he calls
‘the climate’ (Kimura 1995, 63). The self that he intends originates in the climate, just as nature
originates in the climate. This means that nature can only exists in opposition to the self, and self
to nature. Self and nature, or said otherwise, subject and object, are therefore equiprimordial.
They are dialectically bound. In this regard, Nishida’s influence is made clear by the following
quote: “How the world finds itself, is how we found ourselves. When we find our selves, the
world finds itself” (Nishida Kitaro in Kimura 1995, 64).85
Climate, as the in-between between self and nature, is taken to have a concrete function in
our lives and society. Kimura explains that the differences between Japanese and Western people
depend strongly on the climate. The climate (in its meteorological sense) determines Japanese
people to expect irrationality and surprise, making them open to discontinuities and disruptions.
Western people are supposed to be equally determined by the climate, and thus, on the contrary,
expect and anticipate rationality (Kimura 1995, 80). These pre-determined characteristics of
people also influence sociality. Japanese people, Kimura claimed, are much more open to
deviations and mental illness.86

In-between human and human: inter-personal Aida

The second form of Aida is the in-between between (two) people. Again, this Aida
precedes the existence or constitution of the two poles (in this case the two individuals).
Although the easiest way to imagine the in-between might be in conversation or direct encounter,
Aida actually transcends this dimension: “Aida is not just a simple relation that connects
different beings but it is the common place where these different beings originate. Each and
every being could only constitute a self on the foundation of this Aida” (Kimura 1992, 37). It is

85
In Chapter 2 a similar idea has been discussed concerning Merleau-Ponty (1968, 123).
86
He based this idea on his observations that melancholic patients in Japan were far less likely to be hospitalised,
in comparison to Germany. He concluded that the difference can partially be ascribed to the tolerance that
Japanese people express towards forms of irrationality, such as those present in melancholia (Kimura 1995, 23).
Such a very strong claim is not otherwise backed up.

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exactly this feature that makes Kimura’s work original in the psychopathology of the self.
Kimura establishes a close connection between the interpersonal in-between and the constitution
of the self.87 However, throughout his works, this remains a difficult and sometimes mysterious
definition: the self is the result of the encounter between persons. “What we call the self is
exactly the act itself of the encounter with someone or something. It is this relation that
engenders the self on the one side and the world on the other. The constitution of the self and of
the world happen simultaneous” (Kimura 1995, 52).
The interpersonal Aida is concretely there in-between real people, it is experienced or lived
space (Kimura 1995, 53). We sense the interpersonal Aida through spheres of affection and
interaction. However, it concerns a more profound relation between selves as well. I only have a
self, I only become a self, if the other in the encounter becomes a self too (Kimura 1995, 94).
Aida is specifically not only the original unity before the distinction between self and other.
Kimura equally thinks of it as a place where the self resides, namely in between and in the
intersubjective space. Our self is not contained in our brain, in our body, or in our mind. It is out
there, in our interaction. “That the real place of being of the self is found outside of the self,
means, that inside becomes outside, and outside becomes inside” (Kimura 1995, 58). 88 The
interpersonal Aida is thus clearly also relevant to Kimura’s understanding of the
psychopathology of schizophrenia.

In-between the self: otherness in and unity of the self

The intra-subjective Aida is the third form of Aida. Again, the same dialectical structure is
displayed (Kimura 1992, 106). The intra-subjective Aida follows from the inter-personal Aida
(Kimura 1992, 107). The in-between, which we experience in the world and especially in
encounters with others, is the condition to experience the in-between in our selves. What does
this mean? There has to be an experience of the otherness of the other, in order to experience
otherness in the self. The self is ultimately taken to be continuously self-creating in a process of
identity and difference (Kimura 1992, 29). A paradoxical relation with others thus emerges: they
are essentially other, and yet simultaneously vital for my self. A disturbed experience of the in-
between, through affection and interaction, would lead to a disturbed formation of the experience
of our self. It will become clear further to what extent Kimura believes this to be relevant for
schizophrenia (Kimura 1992, 124).

87
Recall that ‘constitution’ can be understood transcendentally, meaning that it determines the experience. The
‘constitution of the self’ thus means that this Aida determines self-experience or self-awareness.
88
This idea is close to some of the positions in the ‘extended mind’-debate and in the enactivistic approach to
cognition (see for example Di Paolo 2009).

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 Kimura notably uses the Husserlian terms of noesis and noema to illustrate what he means
by this third in-between. Noesis is the act of being conscious of an object (intentionality), while
the noema is the object in the conscious act (as intentional correlate) (Husserl 1976, 200). People
are able to become explicitly conscious of their own consciousness, but only for a short while. In
terms of noesis and noema, this would be the noesis of a noesis. Becoming self-conscious of
one’s own consciousness changes the self. The consciousness of which one becomes conscious
becomes objectified and other. It is my own subjectivity, but at the same time, it seems not to be
mine anymore.89
Kimura calls this kind of self-experience ‘Jikaku’. It is the moment where I try to actively
experience my self or reflect on it, and immediately experience a part of my self as other. “I
found myself in a place that seems my own. This secret space was the home of the back-world of
my proper existence” (Kimura 1982, 187). Although the reflected self seems other and becomes
objectified, we still experience it as part of our self. Only when the otherness in the reflected or
objectified self is not recognised as mine, might it become frightening and threatening. This is
actually one of the core disturbances in schizophrenia, as it will be made clear in what follows
(Kimura 1992, 127). Kimura conceives of the self as dynamic. The self continuously tries to
overcome the otherness inherent to it. “The concept of ‘self’ has two different but inseparably
interpenetrating aspects. In the first instance it refers to that sameness or identity, the way in
which, unharmed by never-ending inner and outer metamorphoses, I always remain the same I.
Yet this continuous identical self is not something which is a completely given from the outset.
Instead, it is something which I repeatedly have to maintain through an ever-new act of relating-
to-the-self” (Kimura 1985, 193). It is thus clearly argued that we share this continuous effort to
achieve a stable self with others and it is in this ‘mutual combat’ that one can truly understand
each other (Kimura 2000, 115). The following quote summarizes Kimura’s overall position on
the three Aida’s: “The self remains constantly ‘between-like’ just as the ‘between’ always
remains subjective, ‘self-like’” (Kimura 1982, 183). It is now time to turn to Kimura’s
description of schizophrenia and see which role is covered by the ‘in-between’ psychopathology.

Schizophrenia
Besides his focus on intersubjectivity, Kimura is probably best known for his work on time
in psychopathology (Cutting 2001). One basic distinction informs his account of time, as he

89
Inspired by Sartre (1943, 296), it has been argued that experiencing the Other as the one who experiences me
(être-vu par autrui), in other words being-for-others is a condition for experiencing one’s own self as objectified.
This, on its turn, is essential for intersubjectivity, as it decentralizes my own position.

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points to the difference between objective or chronological time and subjective or lived time
(Kimura 1992, 73). According to Kimura, lived time is essentially characterized by its
orientation towards the future. He then distinguishes three possible time-orientations each
characterizing specific disorders, namely post-festum, intra-festum, and ante-festum (literally
‘before’, ‘during’, and ‘after the feast’) (Kimura 1992, 68). The idea is that these three basic
orientations are normally well balanced, while in psychopathological cases one of them might be
dominant.90 He furthermore claims that schizophrenia involves a domination of the ante-festum
orientation. According to this account, the schizophrenic patient seems to anticipate the future.
However, their acts, thoughts, and speech are often incomprehensible thus preventing the
understanding of what exactly the patient is anticipating. It is extremely difficult for clinicians to
understand patients concerns, as they do not share the same ante-festum orientation. The future
anticipated by the patient might seem empty, and the patient’s activities may then seem
meaningless. According to Kimura, the ante-festum orientation and the concrete manifestations
thereof, such as fear and anxiety, are the consequence of the patient’s awareness of losing a
stable self in an intersubjective world (Kimura 1992, 79, 144). The anticipating attitude is then
an attempt to protect themselves against threatening otherness. Interestingly, this anticipating
orientation can be compared to Jaspers’ ‘delusional mood’ (Fuchs 2005b). Patients may attempt
to control this otherness, by giving their own meaning to the world. It is indeed often the case
that common objects have rather idiosyncratic meanings for patients. Another topic relevant to
Kimura’s concept of schizophrenia is that of ‘meta-noesis’ (Kimura 2000, 49). Three meanings
can be ascribed to meta-noesis. First, it stands for our becoming aware of ourselves as being
aware of ourselves. As previously argued, such meta-noesis is critical for being self-conscious.
Thereby, it could be compared to a form of higher-level consciousness.91 The second meaning of
meta-noesis is even more interesting for the purposes of this research. “Intersubjective Aida
functions as a meta-noetic principle that integrates the diverse intra-subjective Aida’s of every
individual” (Kimura 2000, 52). By employing the metaphor of an orchestra, Kimura explains
that this kind of meta-noesis is a ‘virtual’ reality in which everyone takes place and that is
constitutive for each individual’s subjectivity (Kimura 1991, 89). The intersubjective reality, the
played music in case of an orchestra, functions as a meta-noesis for every individual’s noetic acts
90
The intra-festum orientation is dominant in what it is now called borderline personality disorder. Patients are
stuck in the now, unable to imagine the horizon of possibilities in the future, as well as to conceive the past as a
meaningful source for the constitution of a stable identity (Kimura 1992, 96). Post-festum is instead the
orientation recognized in melancholic depression, where questions of guilt arise, and patients are concerned by
the impossibility of overcoming acts of the past. Thus, in the post-festum orientation suffering results from the
idea of being too late to change anything in the situation.
91
Sartre (1943, 19) concluded that higher level consciousness does not solve the problem of self-consciousness,
as we are confronted with an infinite regress.

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in experiencing the world. It is worth recalling that Husserl (1973b, 199, 205) similarly described
how transpersonal consciousness (überpersönales Bewusstsein) determines our subjective
experience. This second form of meta-noesis is also explicitly related to temporality. The meta-
noesis is considered to be ahead of every particular or individual act. Lived time is thus related to
the ‘sensus communis’, which guides the particular noetic act. “The practical and active
relationship of the subject towards the world is internally directed by a meta-noetic prospective”
(Kimura 2000, 72).92
The third meaning of meta-noesis refers more closely to pathology, and more specifically
to a disturbed form of self-awareness in schizophrenia. Kimura borrows this idea from Japanese
psychiatrist, Nagai Mari, who called it “simultaneous reflection” (Kimura 1992, 117). Kimura
distinguished ‘subsequent reflexion’ from ‘simultaneous reflexion’. The former is said to often
occur after an act or an event, as the subjects thinks about it. The latter amounts instead to
thinking while thinking and thinking about this thinking. This is a form of reflexion that is
probably less prevalent in non-schizophrenic persons. Contrary to the normal noetic and
noematic opposition, the simultaneous reflexion is noesis of noesis. It remains unclear, however,
how the pathological form of ‘simultaneous reflection’ is distinct from the other two kinds of
meta-noesis. Nevertheless, the idea of this ‘simultaneous reflexion’ is compatible with the
contemporary ideas on hyperreflexivity.
Based on Kimura’s descriptions, it could be claimed that schizophrenic persons have more
difficulties to integrate otherness as a part of their self-experience. In certain delusions, such as
paranoia, patients can describe other people chasing them or planning dramatic events to hurt
them, but what is different in schizophrenic delusions is that these others are not real other
beings, but rather expressions of otherness in one’s own subjective sphere. A peculiar kind of
otherness comes to the foreground, an otherness that is deeply embedded in the subjective
experience of the world. The crucial process thus consists of self-alienation. The self, or parts of
it, are not recognised as being self anymore (Kimura 1992, 65-66). Arguably, whenever the
reflecting self is alienated, people experience themselves to be at the centre of observation by
others. On the contrary, if the reflected self is alienated, while the reflecting self is not, then
patients might recognize an other in their own intimate sphere, leading to passivity experiences
and delusions of being influenced (Kimura 1992, 119).

92
The exact meaning and consequences of this temporal meta-noesis remain enigmatic in his work. In Chapter 4,
when discussing the term ‘open subjectivity’, this point will be further discussed.

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 A disturbance of the in-between
What is exactly, according to Kimura, the role of intersubjectivity in schizophrenia? As
previously explained, Kimura claims that our selves are not in our brains, in our heads, nor are
they in us. The self is out there, in the shared world, in the in-between. The reader may recall
Husserl’s hypothetical situation where a universal plague has left only one subject alive. This
hypothetical example was meant to clarify that intersubjective perception does not depend on the
immediate presence of others. Kimura makes indeed reference to the same situation, but, this
time, the subject is a schizophrenic person. He then wonders whether this person could be
considered schizophrenic. His conclusion is that “in fact, with no interpersonal relations in play,
there would not even be schizophrenics” (Kimura 1992, 36). First of all, the symptoms of
schizophrenia, such as schizophrenic autism, would not exist, because there are no others to
escape or withdraw from. Secondly, the delusional or hallucinatory reality would not exist as
separate or different. The person would not live “next to reality”, as Bleuler (1955, 338) wrote,
since there would be no shared reality to begin with. Third, and most importantly in order to
understand Kimura’s concept of schizophrenia, provided that schizophrenia is a self-disorder, the
solitary person left alone in the world would not be schizophrenic (Kimura 1969, 33). In order to
suffer from a self-disorder, one has to have a self, and in order to have or become a self, we need
an opposition, an otherness met in encounter. If there are no others in this world, there is no self
and thus no self-disorder. Once more, the same question arises, which ensues from Husserl’s
description of the I in opposition to the not-I, namely: does the self only emerge out of the
interpersonal relation with others, or can one persuasively claim that ‘objective’ otherness
suffices? Kimura answers that only the otherness of another person I encounter is real otherness
and only this kind of otherness could offer me ‘mineness’ and ‘ownness’.
Within such a framework, schizophrenia is then clearly a disorder of intersubjectivity, not
just inasmuch as it disturbs normality and the relation with others, but also because what is
altered is the intersubjective dimension of experience and life in general. Kimura understands
intersubjectivity to be at stake in the very roots of selfhood: “The schizophrenic process takes
place exactly at the roots or principle of individualization, where the self constitutes itself”
(Kimura 1992, 66). Kimura insists that intersubjectivity should be understood as a profound
element of the self: “Schizophrenia does not involve an illness in a single patient but much more
a happening of the ‘between’ as such, a happening which ontologically always proceeds every
factual being-a-self” (Kimura 1985, 195). This is the core of Kimura’s ideas. One last element to
be discussed is that of ambiance. Previously introduced as a key feature of Minkowski’s ideas,
similar suggestions can be found in Kimura’s work. Already in one of his earliest publications,

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Kimura introduces the word ‘Ki-Chigai’, which is often used in Japanese to describe
schizophrenic patients. ‘Chigai’ means ‘what is deviating’ or ‘what is different’ (Kimura 1969,
28). Schizophrenic patients are thus called deviant from ‘Ki’. ‘Ki’ is the common atmosphere.93
The schizophrenic does not participate in Ki. However, Ki is present in our experiences. We
perceive intersubjectively, as also emphasized by Husserl’s concept of transcendental
intersubjectivity. Ki is transcendental intersubjectivity, nevertheless it is defined as a sphere,
something actually present, namely the in-between that surrounds us (Kimura 1975, 437).
Kimura thus relates transcendental intersubjectivity to its interpersonal origin.
To conclude, Kimura is the first to claim that schizophrenia is a disturbance of the in-
between. To be clear, an affection of the self is not thereby excluded. However, the self here
envisaged normally emerges from interpersonal encounters only. The otherness of the other is
integrated in the self, leading to constitutive splitting through reflection and self-objectification.
However, when this process is somehow disturbed, this leads to self-alienation, which, on its
turn, might manifest in delusions or hallucinations.94 The otherness in the self only becomes a
threat when it is not recognised as a part of the self. The pathological meta-noesis is then best
compared to simultaneous or hyper-reflection. Lastly, he argues that schizophrenic people
experience a different temporality, namely a dominant future anticipation, thereby decoupling
from the shared ambiance or Ki.

3.1.6 Blankenburg
Structural psychopathology
Wolfgang Blankenburg (1928-2002) was a German psychiatrist best known for his work
on schizophrenia, especially for his book Der Verlust der natürlichen Selbstverständlichkeit
(1971). Blankenburg presents in this book the case study of a symptom-poor schizophrenic
patient, Anne R. Furthermore, he more generally includes useful remarks on the application of
the phenomenological methodology in psychopathology. It is then useful to briefly discuss his
methodological principles, before accounting for his ideas on schizophrenia.
Blankenburg’s methodology is both self-critical and open. He believes clinicians should
engage with patients in a pre-scientific manner, before all classification and categorisation based
on diagnostic charts (Blankenburg 1971, 23; 1991a). Blankenburg’s phenomenological method

93
In his later work Kimura replaces ‘Ki’ with ‘Aida’.
94
Kimura claimed that the modern concept of schizophrenia, as characterized by hallucinations and delusions, is
a misconception based on a Western bias. Since Descartes, Western society, at least as Kimura sees it, still thinks
of humans as ‘res cogitans’, as thinking things (Kimura 1975, 434-435). This is the reason why phenomena of
psychosis are so important to us. Indeed, psychosis is often defined as an extreme form of irrationality.
Schizophrenia could be understood differently without this cultural bias, he claimed.

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is inspired by both Husserl’s and Jaspers’ phenomenology (Blankenburg 1971, 13; Micali 2014).
Nevertheless, he aspires to go beyond the limits set out for phenomenology by Jaspers.
Furthermore, he tends to question all those disease entities that Jaspers seems to simply accept,
without any ‘epoché’ (Blankenburg 1971, 15). 95
Blankenburg’s phenomenology is then
something more than descriptive psychopathology. He attempts to search for the essential (the
‘eidetic’ in Husserl’ terms) alterations of an illness. Finally, he conceives of these alterations as
disequilibria in a dialectical process (Blankenburg 1971, 59). 96 According to his perspective,
potential disequilibria concern how the self, the world, and others are related to each other; All in
all, Blankenburg’s ‘structural’ (Blankenburg 1971, 21) approach integrates a transcendental
inquiry into the empirical or natural contact with the patient. Anne’s case, for example, starts out
with a biographical and social description, then combined with the transcendental study into the
constitution of the world of the patient.97

Anne R.‘s symptom-poor schizophrenia

As a patient Anne R. is highly reflective on her own experiences, and surprisingly
conscious of the abnormality of her own behaviour (Blankenburg 1971, 63). Anne describes how
she is often suffering from what is generally known as hyperreflexivity. Certain thoughts
continuously accompany her. These thoughts are partly involuntary, and she describes them as
Denkenmüssen (having to think) (Blankenburg 1971, 36). She experiences these thoughts as
attempts to compensate for something she seems to be lacking, something she fails at. Her
mother reports her often saying she doesn’t succeed at what is essentially human. What it is that
she is lacking, she calls ‘self-evidence’, meaning the self-evidence of how people are, act, and
interact (Blankenburg 1971, 38). According to Blankenburg, the increased reflexivity and
heightened awareness of her own incapacities is secondary to some more basic disturbance
(Blankenburg 1971, 54).
Anne R. calls her problem a loss of natural self-evidence (Verlust der natürliche
Selbstverständlichkeit) (Blankenburg 1971, 39). This is taken to entail a distinctive
incomprehensibility of others. This difficulty in understanding is manifested in different
dimensions, for example in language. She has indeed difficulties in using common expressions

95
In his article entitled ‘What is experiencing?’ Blankenburg (1975) explains the incorrect assumptions about
‘mere experiencing’ in descriptive pathology as inspired by Jaspers. Blankenburg’s simultaneous appraisal and
commentary on some of the key issues in Jaspers’ work (Blankenburg 1984) shows their mutual differences.
96
The introduction of dialectics and the disturbance thereof helped Blankenburg to avoid many normative
assumptions. This is a different use of dialectics compared for example to Kimura’s theory of schizophrenia.
97
This is not unproblematic. A transcendental investigation concerns generalities of consciousness, while
empirical psychopathology concerns the real, singular patient in the encounter (Blankenburg 1971, 18).

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and symbols. Blankenburg describes this as follows: “Often one had the impression that it was
not the patient, but the (schizophrenic) alteration itself, which tried to express itself in stuttering
words” (Blankenburg 1971, 42). He also remarks that she comes close to the boundaries of
common language. However, he believes that her linguistic difficulties actually express some
more profound pre-predicative alteration (Blankenburg 1971, 49).
The natural self-evidence is something “so little, so strange, something important, without
which no one can live”, Anne says (Blankenburg 1971, 42). Another of Blankenburg’s
schizophrenic patients pointed to the same problem in language, namely the ineffability of the
experiences: “There is no language for it, because normal people do not perceive these psychic
states, they live in them” (patient Hans J.K. in Blankenburg 1971, 125). Anne attempts to
describe the alteration differently, and outlines some connection to her incapacity to fit into
certain rules: “Every human should know how to behave, has a direction, a mind-set. His acts,
his humanity, his sociality, and all these rules of the game, which he executes: until now I have
not been able to recognise them clearly. I lack the foundation” (Anne R. in Blankenburg 1971,
42).
Failing to understand the rules tacitly, Anne is unable to connect to others and experiences
social exclusion. But what was it that she feels she is lacking? Even though she tries to copy
others in order to follow the complex rules of social interaction, she can not connect to them
(Blankenburg 1971, 49). She becomes more and more self-conscious, which does not help in
making interaction fluent and natural (Blankenburg 1971, 114). What she lacks is then not
knowledge, but some basic certainty: “Even then, when the healthy person doubts radically, the
self-evident everydayness of Being remains the ground and foundation: every question and doubt
remains within a larger realm of self-evidence” (Blankenburg 1971, 75).
Natural self-evidence is what makes every action and interaction possible, but it also
grounds doubt and uncertainty. It is the one foundation that we do not doubt, as it usually
precedes our reflections. In fact, natural “self-evidence reigns even before the principle of
rationality appears” (Blankenburg 1971, 77). This pre-reflective, pre-predicative self-evidence is
connected to others. As it has been argued in Chapter 2, we integrate a set of rules into our own
subjective experiencing, judging, and acting, which makes it shared. According to Blankenburg,
schizophrenia affects exactly the relation between intersubjectivity and pre-reflective, pre-
predicative subjectivity.
The structural approach elucidates four dimensions or domains that are relevant to the
schizophrenic alteration. The first is the relation of the person to the world. The second involves
a change in temporality and time-experience. Third, Blankenburg examines the I-, Ego-, or self-

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constitution, and how this relates to natural self-evidence. Lastly, and most importantly for this
study, he investigates particular changes to transcendental intersubjectivity (Blankenburg 1971,
77, 78). The current investigation is mostly interested in the last two.

Self and self-evidence

One could argue that the self (Selbst) that appears in Anne’s notion of self-evidence
(Selbstverständlichkeit) has little or nothing to do with the subject’s ‘self’, or with concepts such
as self-awareness, sense of self, or ‘ipseity’. The word ‘self’ could well mean here something
entirely different. However, Blankenburg argues that, in fact, they are strongly related. One may
then wonder what exactly is the self (as in subjectivity) according to Blankenburg? Remarkably
he uses the terms ‘I’, ‘Ego’, and ‘self’ interchangeably. The disturbance that he investigates in
Anne’s case is not a psychotic disorder, but it is a pre-psychotic (subapophäner, vorparanoider)
alteration of the self (Blankenburg 1971, 94, note 85).
What is then the relation between the self and self-evidence? Blankenburg explicitly claims
that: “Natural self-evidence and Self-being are dialectically related. Self-evidence (Von-selbst-
sein) and Self-being are complementary” (Blankenburg 1971, 98). One could argue that self-
evidence follows from the self-being (Selbst-stand). A loss of natural self-evidence would then
ensue from a weakening of the self. However, one can also argue the other way around: the
weakening of the I follows from a lack of pre-given self-evidence. In Blankenburg’s own words:
“The dialectical moment of it is that, without an interruption of natural self-evidence, there
would be no space for self-being of an I. On the other hand, were this interruption too large, self-
being would have no foundation to develop from” (Blankenburg 1971, 98). Self-manifestation,
in this view, is not only a question of stabilization and ‘fitting in’, but also of differentiation. In
this latter respect, this view can be compared to Minkowski’s idea of the ‘élan vital’ (Minkowski
1995, 34-35), which forces us to break out of the ‘ambiance’ to become someone.
Although it is not entirely clear how self-evidence and self-being relate one another, it has
been established that they are in a dialectical, rather than in a foundational relation. It has been
established as well that self-evidence is some kind of pre-reflective, pre-predicative basic trust
(Blankenburg 1971, 97). This basic trust is something different from trust in oneself, to have
abilities or talents to undertake certain actions. Anne describes, for example, her difficulties to
engage in everyday interaction with others. This, however, is not specific to her illness and it is
not this kind of uncertainty that Blankenburg refers to (Fuchs 2014b). There is something more
profoundly uncertain about her, which does not primarily involve self-confidence (Blankenburg
1971, 99-100). Other patients find other forms of self-evidence to compensate the lack of basic

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trust. Hans S., for example, would sit at a table in a restaurant with special gloves, for which he
has no explanation, as he reacts to questions with a self-evident “just like that” (einfach so)
(Blankenburg 1971, 123). One may still wonder, however, what makes this special kind of self-
evidence inadequate? Or more specifically, what is it about the constituting of the world for the
subject, that is going wrong for Anne, and that leads to a lack of basic trust and to inadequate
attempts to compensate for it?

Intersubjectivity
Blankenburg is sure that intersubjectivity plays a role on both an empirical (or natural) and
a transcendental level of our lives.98 The empirical or natural level is what we encounter in the
Lebenswelt or the life-world. It is here that all deviation from Erwin Straus’ “axioms of the
everyday world” is experienced (Straus 1956, 391; Blankenburg 1971, 21; Summa 2014b).
These axioms of the everyday world are important for both self-evidence and self-being. 99
Minkowski already indicated the role of rules in our lives and in how we recognize others to fit
in, or not. The rules Anne talks about are not guidelines that can be explicitly taught or learned.
Instead, they require a certain ‘know-how’ (Blankenburg 2001). For another patient the same
problem occurs, as he does not know “how to get into the meaningful generalities of the others”
(patient Helmut W. in Blankenburg 1971, 80). The rules are arguably not random, ad-hoc
constituted structures, but they are meaningful and have grown historically. They are
furthermore ‘in-the-world’, they are not transcendental themselves. Most patients are, however,
not aware that they lack this know-how, or lack the tacit understanding of the rules (Blankenburg
1971, 80).
The previous discussion of Husserl’s intersubjective perception in Chapter 2 elucidated the
function of the transcendental categories or constitutions (Entwurfe). However, the reader may
still ask: how and when is a particular constitution, category, or a set of rules appropriate? In
Blankenburg’s words: “Which category can I use, and which not? All similar questions seldom
appear in the mind of healthy individuals – at least not as practical questions that determine how
everyday life should be lived” (Blankenburg 1971, 82). Usually, we do not ask ourselves these
questions, and only in particular cases we are confronted with them and their meaning.

98
This is Blankenburg’s distinction. He used the term ‘empirical’ here to refer to the domain of the natural
attitude and to everyday life interactions.
99
Blankenburg refers to Descartes, who, in his attempt to ground scientific certainty on the method of doubt, was
well aware of the risk of losing every certainty. Therefore, he had to remain rooted into everyday life. He had to
find the ‘bon sens’ (Descartes 1902, 1).

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Sometimes children, unaware of tacit rules, ask for an explanation of these rules. Another extra-
ordinary example is Anne’s case, whose suffering makes the existence of these rules explicit.
On the whole, self-evidence and the background beliefs we hold do not seem subjective to
us. We experience them as already there, as stable and unquestionable (Blankenburg 1971, 82).
Fashion offers a good example: it would be difficult to rationalize why a particular piece of
clothing is suitable on a particular occasion. We somehow sense this: “The different motivational
qualities, which a clothing fabric might have, always already carry a complex intersubjective
process of judgements with it, which are not transparent to us. And the factors that influence our
judgement are not separable into singular factors (conventions, fashion, artistic qualities,
personal memories, etc.)” (Blankenburg 1971, 82). One specific feeling helps us in such cases,
namely ‘Feingefühl’ or ‘Weltgefühl’. This feeling can be best translated into ‘common sense’
(Blankenburg 2001).100 In close correspondence to Kimura’s ideas, another patient often repeats
that he lacks a particular in-between (Zwischen) that connects healthy individuals to their world
(Umwelt), an in-between that simultaneously connects us, and guaranties distinction and distance
(Blankenburg 1971, 86). This feeling of lacking an in-between is something Anne also describes
when she says that she fails to experience an affective connection towards others and the world
(Blankenburg 1971, 87).
On an empirical level, these difficulties relate to social isolation. On the transcendental
level, instead, Blankenburg recognises two basic reactions to the schizophrenic alterations. In the
first case, as it is the case with Anne, patients may try to compensate hyperreflectively what they
lack in implicit know-how. Accordingly, Anne describes herself echoing the acts and styles of
others (Blankenburg 1971, 49). A second possibility is that patients withdraw into isolation, or
present meaningless negativism, stupor, or mutism (Blankenburg 1971, 115). Due to the
disturbance of intersubjectivity, one does not only struggle to cope with implicit rules, but also
with the direct encounters with others. Anne describes, for instance, an encounter, where she was
“lifted out of the saddle”, and experienced how she had no real access to others (Blankenburg
1971, 107).
The core of the schizophrenic alteration, Blankenburg claims, is found in the
intersubjective constitution of this pre-reflective, pre-predicative life-world. Here, a more
specific definition of the rules Anne points to is provided. Namely, these rules are taken to be

100
In the introduction I have summarized Stanghellini’s interpretation of common sense (2001, 205). He clarifies
that ‘common sense’ has a double meaning. Firstly, it refers to a “stock of knowledge-at-hand useful at the level
of everyday life”. It thus involves a “network of beliefs” that is shared with other members of the community,
and it consists of the rules that determine how we act in a given situation. Secondly, it is represented as a “sense”
useful for attuning with what is “common”. The second meaning thus involves a psychic capacity aimed at
understanding current social situations.

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common sense categories that only function inasmuch as individual subjectivity is rooted in the
intersubjective life world (Blankenburg 1971, 113). In the second section of this chapter, it will
become clearer how transcendental intersubjectivity becomes disturbed, and how schizophrenic
delusions are clear examples thereof.
In Chapter 2 the intersubjective component of experience has been given philosophical
proof. According to Blankenburg, the basic trust we have in our experiences is not related to a
particular quality an experience might have, nor does it involve a particular content. Basic trust
follows, instead, from the forms of experience we have in a situation. The adequacy of these
forms expresses a pre-intentional relation to the world. “This relation to the world is not the
consequence of thought content, but of forms of thought, of ways of thinking. This means that
they are categorical capacities that allow our concrete thinking, feeling, and wanting to let the
encountered be transcendentally constituted” (Blankenburg 1971, 116). The organisation of the
relation between world and self is precisely the task of these categories. The categories
themselves find their origin in the world. They are mundane in the sense that the life-world
influences these categories. The life-world is the constituted world in between people.
Transcendental intersubjectivity thus refers to the intertwining of two elements: the first is the
transcendental constitution of the world for a subject; the second is the mundane intersubjective
ground where the categories, the forms of thinking and sensing originate and become regulated.
Blankenburg’s phenomenology brings out the transcendental inquiry. The relation between
self and world, between self and other, between I and We is said to be eminently dialectical
(Blankenburg 1971, 117). The reader has already encountered this dialectical appreciation in
Kimura, although this latter mainly understands the dialectical appearance of self and other in
interaction and encounters. Here, the dialectical process is described in relation to the
transcendental constitution and experiencing of the world. The form is here triadic, rather than
dyadic. “We have seen how self-evidence and Self-being are not only related to each other, but
both to the interpersonal reality. The other is not just a special case of appearances in the world;
the relation to the other rather shows itself – when this is intersubjectivity-constituting and thus
world-constituting – as a constituting moment, that influences the inner world and the natural
self-evidence of human Being” (Blankenburg 1971, 121).

Intersubjectivity and delusions

Although Blankenburg considers psychotic symptoms as non-essential sedimentations of a
prior alteration (Blankenburg 1971, 100), he discusses schizophrenic delusions in more detail in
an edited book on delusions and perspectivity (Blankenburg 1991b). Delusions are taken to be by

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definition predicative, that is, expressions and judgements about something. Blankenburg is,
however, more interested in what precedes them (Blankenburg 1991b, 5). According to him, the
same lack of basic trust, the same groundlessness (Bodenlosigkeit) is hidden behind the absolute
certainty of the delusion (Blankenburg 1971, 7). He suggests that the development of
hallucinations and delusions is preceded by a phase that functions as a surrogate for interpersonal
relations. The more this surrogate becomes objectified, the closer we come to hallucinatory
experiences and delusions. In other words, if there is a disturbance in intersubjectivity, then this
might be compensated unconsciously by phenomena that relate to others: hearing a voice, seeing
a figure, assuming the presence of others where none are present. The symptom-poor form of
schizophrenia would then precede the objectified phenomena as delusions (Blankenburg 1971,
49).101
In the edited volume on delusion and perspectivity, Blankenburg discusses the view that
delusions express a lack of multi-perspectivity (Blankenburg 1991b, 1; Breyer 2014).
Perspectivity, he explains, has two sides. It firstly implies experiencing ‘more reality’, inasmuch
as one has more perspectives. Interestingly, in the history of art, the introduction of perspective
in painting meant a tremendous leap towards realistic painting. The second side of perspectivity
refers to its relativity: every perspective somehow denies the former, and every perspective
points out its relativity (Breyer 2014, 180). Arguably, it is not the flexibility of perspectives per
se to be disturbed in delusions. Rather, it is its intersubjective attunement. However,
intersubjectivity alone is not enough for a normal experience of reality, as it can be inferred from
the following statement: “A these of many old epistemological theories, which made the
approach of delusions more difficult, was that the ‘world’ is just a ‘presentation’ that humans
have, and nothing more. If that were the case, than the only criterion for delusions would be a
lack of intersubjective confirmation. A criterion, which is important, but which does not suffice
on its own” (Blankenburg 1991b, 10). Blankenburg argues that an unlimited increase of
perspectives does not lead to more reality. The inconsistency of different perspectives might give
more reality than an ever-increasing amount of perspectives. Remarkably, he concludes that the
irreality of my experiences, the fact that one experience might deny an earlier one, makes my
experience of an object more real (Blankenburg 1991b, 26). Intersubjectivity is thus not the only
factor at play in the experience of reality and in its deviations. As Blankenburg suggested, a
concise study of reality experiences is required to show what factors are there at stake
(Blankenburg 1991b, 10). In the next part of this chapter, I will discuss this question in more

101
In section 3.2.1 it will be made clear why this suggestion on ‘surrogate others’ is problematic.

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detail with regard to delusions and other phenomena of hypo- or hyperreality in
psychopathology.
Blankenburg’s ideas on schizophrenia and their relation to intersubjectivity can be finally
summed up as follows: Firstly, precisely the pre-reflective, pre-predicative self-evidence, which
Anne R. has lost, is taken to be the essence of schizophrenia. Subjective self-evidence is
furthermore related to shared self-evidence or ‘common sense’ through transcendental
intersubjectivity. This perspective emphasizes the influence of intersubjectivity on how we
experience the world and how we categorize our perceptions and meanings. As a result, also our
individual ‘basic trust’ relies on intersubjectivity. Secondly, schizophrenic patients have
difficulties interacting along the “axioms of every day life” (Straus 1956). Rules and know-how
seem to fail to be integrated. Hyperreflexivity is then understood precisely as an attempt to
compensate for these difficulties. However, it is a vain attempt, as these common sense rules are
less a matter of knowledge than of know-how and of attuning to the others. Hyperreflexivity is
moreover not the only compensatory attempt. Patients may also withdraw into isolation or
become mutistic. Lastly, intersubjectivity is taken to play an important role in delusions.
Delusions could be then understood as surrogates for an already difficult relation to others. The
lack of others and affective attunement would then be compensated by unreal others. This idea is
however problematic and requires further investigation. Finally, a disturbance of
intersubjectivity is taken to lead to the incapacity to integrate the intersubjective perspective on
the world with one’s own subjective perspective, making it difficult to understand unwritten
rules or to have adequate social contact.

3.1.7 The contemporary neuropsychological approach to schizophrenia

The last theory I wish to discuss in this chapter is that of Chris Frith and other researchers
who claim that the essence of schizophrenia involves a disturbance of a ‘theory of mind’ (ToM).
I will summarize and discuss this theory with particular attention to its intersubjective elements.
It will be made clear to what extent this approach differs from the others, and to what extent it
can offer a different insight into the intersubjective disturbances of schizophrenia. Contrary to
the previously discussed psychopathologists, Frith develops a theory of schizophrenia based on
cognitive psychology. Cognitive psychology, or information processing psychology, considers
the mind to function as a computer (Frith 1992, 9). As it has been explained in the introduction,
the uncertainty associated with the diagnostic classification (DSM) has encouraged the rise of
different theories. Within this varied context, Frith’s hope is that his theory could offer a rational
classification scheme for signs and symptoms, which could then be used for experimental testing

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(Frith 1992, 67). The underlying assumption to his theory is that cognitive deficits are the
manifestation of some disorder in the brain (Frith 1992, 13, 33).102
In order to understand Frith’s theory, we need to clearly distinguish between symptoms
and signs. Symptoms are the experiences of the patient as they are expressed by the patient.
Signs are instead objective, in the sense that they can be objectified or perceived by someone
else other than the patient. They might even be measurable changes in behaviour, recorded by
the clinician (Frith 1992, 12). From a methodological point of view, Frith stays close to a
symptoms- and signs-based attitude towards schizophrenia, rather than embracing a theory of
schizophrenia in general. “Since I am trying to explain signs and symptoms rather than
“schizophrenia”, my enterprise will not be hopelessly compromised if the definition of
schizophrenia is revised” (Frith 1992, 9), he claims.103
As previously emphasized, some phenomenologists have claimed that negative signs are
more essential to the disorder than positive symptoms (Minkowski 1966; Blankenburg 1971).
There are different reasons for this. One of them concerns the specificity of positive symptoms,
which is taken to be not particularly high, due to other disorders also reporting for instance
hallucinations or delusions. However, according to Frith, and not unimportantly for our
perspectival shift towards intersubjectivity, positive symptoms play indeed a vital role in the
pathogenesis of schizophrenia. In fact, Frith even calls positive symptoms “core features” (Frith
1992, 34). As the reader might remember, both Bleuler and Minkowski claim the opposite,
calling positive symptoms ‘accessory’ (Bleuler 1955; Minkowski 1966).

Theory of Mind in schizophrenia

The theory of mind (ToM) is one of the most famous notions in psychology and
philosophy today. Originally, it was used by primatologists and psychologists, Premack and
Woodruck (1978), who studied chimpanzees and discussed whether they had a theory of mind.
They claimed that, in order to interact with others, one needs to assume that the other has a mind.
This capacity is believed to have emerged in hominid evolution as an adaptive response to an

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The reorientation towards the brain is related to the chance discovery of antipsychotic drugs and their
association with dopamine, and to the evolution in brain imaging based on quantitative methods (Frith 1992, 16).
The contemporary view on this was discussed in the introduction, where a possible approach to schizophrenia
was described in reference to Kapur and Van Os (Kapur 2003; 2004; Van Os and Kapur 2009). Famous
examples of these quantitative results of brain research are the enlarged lateral ventricles (DeLisi et al. 2006).
103
Focussing on symptoms and signs does not mean neglecting the first person view, however. Hallucinations
are not explained primarily as the consequence of a brain deficit, but rather as a “a subjective phenomenon lying
within the realm of the mind” (Frith 1992, 27). This sounds like a phenomenological attitude towards the
symptoms of schizophrenia. It is only after analysing the experience of the patient (symptoms), and the
perceivable alterations of behaviour (signs) that one could possibly theorize about aetiology.

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increasingly complex social environment (Brothers 1990). Several similar concepts describe the
same capacity: ‘mental state attribution’, ‘taking the intentional stance’, ‘mentalizing’, and
‘reflexive awareness’ (Brüne 2005). These similar cognitive approaches share the idea that, in
order to understand others and to act and interact in the world, we need to have representations
of the world of objects, and of others. These representations are not enough, however. We also
need a representation of our representations, i.e. ‘meta-representations’. Meta-representations
allow us to think, reflect, and theorize about our representations. Frith argues that in
schizophrenia the representation becomes dysfunctional, leading to deficits in the three main
areas of sense, that of willed actions, that of self-monitoring, and that of monitoring others and
their intentions.104 Concerning willed actions, according to Frith, we have two major sources of
action: “Some actions are carried out directly in response to environmental stimuli. Others are
seemingly spontaneous and self-initiated” (Frith 1992, 43). It is the latter kind of actions that
show to be dysfunctional in schizophrenia. Parkinson patients, on the contrary, feel prevented
from acting by a difficulty related to the motor output, rather than to the initiation of action.
Parkinson patients do intend to perform an action, but they are incapable to do so. The
schizophrenic patient, on the other hand, could easily be guided or ordered to perform an act, but
self-initiated actions seem to be difficult: “The patient with chronic schizophrenia probably has
no action in mind to perform” (Frith 1992, 55). The patient might have a plan or a goal, but he is
unable to turn it into the appropriate action. This, Frith claims, leads to the typical signs of
poverty of action, perseveration, and inadequate actions (Frith 1992, 101).
The second component of the dysfunction in meta-representation involves self-monitoring,
as it can be reported in hallucinations. Frith claims that auditory hallucinations are actually
correlated to inner speech: “The problem is not that inner speech is occurring, but that patients
must be failing to recognise that this activity is self-initiated. The patients misattribute self-
generated actions to an external agent” (Frith 1992, 73). The same thing goes for passivity
experiences as thought insertions and delusions of control. The same mechanism can be
described in delusions: when a patient says that thoughts that are not his own are coming into his
head, this implies, similarly to hallucinations, that the patient is not able to recognise his own
thoughts as his own. “It is as if each thought has a label on it saying “mine” (Frith 1992, 80),
which seems to be absent in the case of thought insertions. Frith believes we have a central

104
The theory of mind is supposed to develop through early life, and especially through the interactions with
others. Developmental research has shown that young children whose parents often use expressions which refer
to mental states when talking to them, pass ToM-tests earlier on in life. But also the presence of older siblings,
who are already capable of more sophisticated ToM, is reported to strengthen young children’s understanding of
other minds (Brüne 2005).

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monitoring system, like a computer. This system breaks down in schizophrenia. “I am essentially
describing two steps in a central monitoring system. First, the relationship between actions and
external events are monitored in order to distinguish between events caused by our own actions
and by external agencies. This enables us to know about the causes of events. Second, intentions
are monitored in order to distinguish between actions caused by our own goals and plans (willed
actions) and actions that are in response to external events (stimulus-driven actions). Such
monitoring is essential if we are to have some awareness of the course of our actions” (Frith
1992, 81). Without this monitoring, there cannot be an awareness of the intended actions,
possibly leading to abnormal experiences. Essential to Frith’s explanation of the positive
symptoms is the breakdown of the ability to become self-aware of our own intentions.
Schizophrenic delusions are not only a disorder of self-monitoring, but also of reasoning
and logic. In addition, the disorder can be said to be very specific: “reasoning fails only in
relation to the understanding of human interaction” (Frith 1992, 79). On the whole, Frith agrees
with Bentall et al. (1991) that the delusions of most psychotic patients seem to concern the
patient’s place in the social universe. The best known delusions are paranoid delusions, and
delusions of reference, and these clearly involve others primarily (Frith 1992, 80). Delusional
patients show indeed a disturbance of ToM, however they are still able to mentalize, inasmuch as
they still attribute mental states to others, even if they are faulty (Brüne 2005, 23). 105
Furthermore, empirical research shows that social reasoning is actually abnormal in deluded
patients. An important conclusion can then already be drawn from the cognitive account
concerning schizophrenic delusions as directly affecting the intersubjective domain. In Frith’s
own terms, what is dysfunctional in the social reasoning of many schizophrenic patients, “is that
they are trying to apply logic in circumstances where normal people would not” (Frith 1992,
80).106

Communication
Not only delusions bear testimony to the dysfunction of social reasoning. The same can be
said concerning certain actions, such as stereotypes and perseverations. In this respect, Frith
quotes John Ferrier, who in 1795 wrote: “When lunatics attempt to write, there is a perpetual
recurrence of one or two favourite ideas, intermixed with phrases which convey scarcely any
meaning either separately, or in connection with the other parts. It would be a hard task for a

105
It has even been argued that some delusional patients, especially paranoid schizophrenic patients, have too
much, or “hyper-ToM” (Abu-Akel 1999; Brüne 2005).
106
Minkowski’s ‘morbid rationalism’ (Minkowski 1995, 260) and Blankenburg’s ‘loss of natural self-evidence’
(Blankenburg 1971) describe something similar.

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man of common understanding, to put such rhapsodies into any intelligible form, yet patients
will run their ideas in the very same track for many weeks together” (Ferrier quoted in Frith
1992, 48). This quote includes a few distinctive aspects of schizophrenia: firstly, written and
verbal perseverations; secondly, difficulties to communicate with others, mainly due to
incoherence; thirdly, he concludes that a man of common understanding (or of ‘common sense’)
has a hard time to understand the patient, pointing to the incomprehensibility also described by
Jaspers.
It should be noted, however, that, according to Frith, the incomprehensibility is part of the
larger difficulty involving the social sphere (Frith 1992, 65). Based on empirical studies, Brüne
argues that schizophrenic patients often show ‘social naivety’ (Brüne 2005, 36). The patients
have problems applying strategic social rules and tactics, and an impaired ToM would be to
blame. Strategic social reasoning was also tested in order to proof the dysfunction of second-
order mental states. This showed that schizophrenic patients have great difficulties to infer what
others are thinking in particular situations, how they will react, and what they think about the
patient and his or her intentions. This strategic thinking in social situations is referred to as
‘Machiavellianism’. Yet, is this really the way we interact with others in normal social
situations? I believe that only in situations of need, as it will be argued further on, such strategic
reasoning are useful and required.
Several empirical studies on the ability of schizophrenic patients to perceive faces and
emotional expressions have led to the conclusion that these patients struggle greatly with
recognizing expressions and could even perceive faces in an abnormal way (Gessler et al. 1989;
Kohler et al. 2010). This is a crucial claim. It could indeed suggest that perception itself is
disturbed, rather than a cognitive mechanism, as Frith intends. In addition, it could well explain
the problem of social interaction: a failure to recognize facial expressions necessarily
complicates the already existing difficulty to monitor other people’s intentions. Causality could
also develop the other way around though: a primary difficulty to infer the other’s intentions and
experiences might lead to not recognizing a particular facial expression as an expression of such
an intention or experience. This is how Frith actually understands the relation, and social
withdrawal is taken to result from this difficulty. The main point, nevertheless, is that the
disturbed ability to make inferences about others’ perspectives might well be the key aspect
making the recognition of expressions so difficult (Frith 1992, 52).
The last accounted social element in schizophrenia concerns language. Many studies have
shown how schizophrenic patients are impaired in their capacity to understand or ‘decode’ and
use language in a pragmatic manner (DeLisi 2001; Brüne 2005, 35; Stephane et al. 2007).

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Language involves indeed a set of conversational rules to transfer meaning in a useful way. In
order to do this successfully, one should be able, to some extent, to infer the mental states of the
conversation partner. I have to infer, for instance, what the other knows already, what he or she
understands, and what the other thinks of what I am telling. Schizophrenic patients may have
difficulties understanding metaphorical speech, as they usually interpret these metaphors
literally; on the whole, they seem to be more impaired with the pragmatic aspect of language
rather than with the syntax or semantics; they also seem to be less able to use context in order to
understand ambiguous verbal material; they finally seem to disregard any shared knowledge
between themselves and the interlocutors (Corcoran and Frith 1996; Brüne 2005; Wible 2012).
Further studies show that the problem of schizophrenic language is not a matter of language
competence, of knowing words and understanding them. It is rather in the interaction with others
that the language of the schizophrenic gets problematic (Wible 2012; Niznikiewicz et al. 2013).
One may wonder, then, whether linguistic abnormalities are just the expression of formal
thought disorders. Frith argues that they are not. According to him, schizophrenic patients’
communication to others of their thoughts is chaotic and incoherent in itself (Frith 1992, 98).
This is apparent in non-verbal communication as well. It is here that Frith’s theory of inference
and monitoring of others is most fruitful. As he claims: “The major requirement for successful
communication is to take account of the knowledge, beliefs, and intentions of the person to
whom we are speaking. This is necessary even for quite simple aspects of discourse” (Frith 1992,
99).107 Furthermore, schizophrenic patients’ communication is said to be asymmetrical: patients
understand normal speech and conversations, but are unable to make themselves understood by
others (Frith 1992, 100).
Some patients generate new words or ‘neologisms’ (Covington et al. 2005). Sometimes
these words describe a commonplace idea, and the neologism functions as an idiosyncratic
signifier for a well known signified. Sometimes the neologisms can instead describe something
entirely new. One could understand these as attempts to express those experiences of theirs, for
which normal language has no words (Frith 1992, 103, 105). Often the patient shows to be aware
of the difficulties within their conversation, but still he or she seems not to change their
communication. The reason for this, according to Frith, is that patients can only monitor their

107
A schizophrenic patient can, for example, talk about a subject (“they”) without actually introducing the
subject to the conversational partner: “You can see they’re like, they’re almost like a pattern with a flower. They
start from the middle” (a patient quoted in Frith 1992, 99). However, the opposite can happen as well: “I see a
woman in the middle of a snow bank, I see a woman in a telephone booth in the middle of a snow bank going
yackety yack yack yack” (a patient quoted in Frith 1992, 100). The second patient does not refer to the already
introduced subject (the woman in the middle of a snow bank) with the adequate pronoun, but repeats the original
description. Both patients fail to understand what the interlocutor already knows.

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responses in conversation after they have ‘emitted’ them. They indeed recognise that what they
have just said is inadequate, but they are not able to ‘edit out’ the bad responses before uttering
them. This would thus show a deficit in monitoring their own intentions (Frith 1992, 105).
Further elements of disturbance are recorded in the awareness of others. Patients fail notably “to
take account of the knowledge of the listener when constructing their utterances” (Frith 1992,
106). Rutter (1985) for example, concluded that the main obstacle to proper communication is
the patients’ difficulty in taking the role of the other. The inability to share conventional social
norms is another element responsible for the intersubjective deficits in schizophrenia and
particularly in communication. Frith (1992, 107) describes this as follows: “Their discourse is
guided, at least in part, by knowledge that is not shared with the listener”.108 In conclusion, the
several difficulties with communication and language are understood by cognitive
neuropsychology as a fundamental issue concerning the ability to make inferences about the
knowledge and intentions of the listeners.

Willed action, self-monitoring, other-monitoring

As previously outlined, Frith relates the positive symptoms and the negative signs of
schizophrenia to three fundamental issues: deficits in willed action, in self-monitoring, and in the
monitoring of others and their intentions. The disturbances of willed action are displayed as
poverty of action in movement, speech, and affect. Extreme cases show abulia, alogia, and
athymia. Frith believes that poverty of action is the consequence of the inability to generate
spontaneous willed acts, which, in their turn, might not only lead to poverty of action, but also to
perseverations and inappropriate actions (Frith 1992, 113). The disturbances of self-monitoring
are instead displayed by what has been called, following Kurt Schneider, first-rank symptoms,
such as delusions of alien control, distinctive hallucinations, and thought insertions. The inability
to monitor willed intentions is supposed to also be the cause of these first rank symptoms. Lastly,
a disturbance in the monitoring of the intentions of others is taken to lead to paranoid delusions,
certain kinds of incoherence, and third-person hallucinations (Frith and Corcoran 1996).
All the above mentioned fundamental issues are taken to be connected to what Frith calls
meta-representation. Meta-representation is thought to be at the centre of conscious experience,
as it is the crucial mechanism underlying self-awareness (Frith 1992, 116). In fact, Frith’s
account is inspired by the application of the theory of mind to childhood autism, where similar
signs can be described resembling schizophrenia, such as social withdrawal, stereotyped

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It is worth asking whether this description really grasps something more than the tautology that schizophrenic
patients do not communicate according to the norm because they have difficulties with social norms.

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behaviour, and a lack of communication (Baron-Cohen et al. 1985). These similarities seem to
suggest that the deficit in autism is related to the deficit in schizophrenia. Both arguably concern
the formation of a theory of mind of the other, in other words ‘mentalization’.109

Critique of Frith’s account

Although Frith’s ideas lend themselves very well to an inquiry into the intersubjective
aspects of schizophrenia, two critical remarks have to be made. The first is a general critique to
the cognitive neuropsychological model. To what extent is it correct to use computational
models to describe consciousness, and thereby to understand psychopathology in terms of
deficits in the ‘cognitive mechanism’? Could it not be that schizophrenia is not just a disorder of
cognition? Where do affection or embodiment come in, for example? Room for these questions
becomes clear if we take a close look at one important aspect of the theory, namely the
interaction with others. Frith claims that: “The difficulty that many schizophrenic patients have
with recognising emotions may be part of a larger problem with making inferences about mental
states” (Frith 1992, 56). Normal individuals are claimed to use inferences to monitor the
intentions of others. To what extent is this true? Do we really need to infer a mental state or even
a theory onto the people we interact and talk with? Daniel Hutto (2010, 44) has argued that
“cognition is something that emerges from the self-organizing activities of organisms” and
“these are constituted by their essentially embedded and embodied interactions with their
environments over time”. In this sense, the cognitive model is missing an essential element:
where does the formation of a theory of mind come from, other than from prior experience
through interactions? One might well claim that: “There is no such thing as a fundamental (and
in-itself still to be explained) symbolic-computational basis for intelligent activity” (Hutto 2010,
44). Cognition is generally taken to emerge from an interaction with others and with the
environment.
With regard to the inference of others, the same problem arises. Frith claims that:
“Inferring mental states has become routine in many situations and achieved the status of a direct
perception. If such a system goes wrong, then the patient will continue to “feel” and “know” the
truth of such experiences and will not easily accept correction” (Frith 1992, 122). Two questions
are however left unanswered. Firstly: how does the inference and theory of mind suddenly

109
Based on the ToM-paradigm, an important difference can be found between autism and schizophrenia. The
autistic child was supposedly never able to grasp the intentions and subjective life of others, while schizophrenic
patients are claimed to lose this ability. The latter may thus still have ritual or behavioural routines for interacting
with others, which do not require a theory of mind or mentalization (Frith 1992, 121). This kind of patient will
continue to make inferences about the mental states of others, but they will often get these wrong, which might
lead to delusional experiences.

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become part of direct perception? Surely, one would agree with the idea that we grasp someone’s
intentions immediately ‘through’ or ‘in’ his or her activity, although possibly incorrectly. For
example, we directly understand that someone who is waiting for a red light wants to cross the
street once it turns green. We do not need to infer what are the actual thoughts of this person, nor
do we need to take his perspective on the matter. We understand the situation directly through
our perception.
The second ensuing question is on what ground Frith can claim that, in routine activities,
we do not need inferences, whereas for speech and other actions we do need inference and meta-
representations. How does the immediate perception of routine activities relate to the cognitive
mechanism described by Frith? Is it really the case that we first develop our cognitive
mechanism, and later on this becomes a routine in interaction? Or might it be the other way
around, namely that through our development as persons we firstly interact, and only secondarily
come into situations where inference and mentalization are explicitly required? Interestingly,
Frith does often acknowledge the role context plays (Frith 1992, 101, 107), and particularly how
schizophrenic patients might be unable to use the context in order to make themselves
understandable to others, or to behave according to contextual norms. However, in Frith’s
account the use of the context again seems to depend on inference, rather than on what Hutto
calls embedded and embodied interaction. From Hutto’s perspective, it seems clear that we do
not need to form a theory of mind, let alone a theory of the mind of the other, in order to
understand and interact with someone else. A second stream of criticism addresses Frith’s
description of self-awareness. As previously pointed out, according to Frith, three main domains
may be affected by deficits in meta-representation, leading, notably, to problems with willed
action, self-monitoring, and the monitoring of others and their intentions. The second among
these domains entails however some unavoidable difficulty. Frith claims that “one cognitive
process likely to be relevant to positive symptoms is that by which we become aware of our own
intentions” (Frith 1992, 85). According to him, therefore, we become self-aware through a
cognitive process, and self-awareness is the essence of consciousness. “In its most highly
developed human form this self-awareness permit us to reflect not only on what we ourselves are
thinking, but also on what other people are thinking about us”, Frith claims (Frith 1992, 87).
However, once more it could be questioned whether it is correct to call self-awareness a
cognitive process, or the result thereof. As it has been explained in the introduction to this work,
phenomenological philosophers have struggled with providing a satisfying description of self
and self-awareness. A crucial point in phenomenology is that self-awareness in its most basic
form is not a cognitive process, nor is it the result of a reflection. Self-awareness is arguably

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related to a first-person perspective that characterize one’s experiences (Zahavi 2008). The kind
of self-awareness proposed by Frith is therefore particularly problematic, as it amounts to some
kind of higher order position on one’s experiences, intentions, and actions. This clearly implies a
subject-object split and the familiar risk of an infinite regress (Zahavi 2008, 21; Sartre 1943).

Summary
For the purpose of this text Frith’s account has offered valuable insights into the different
symptoms and signs of schizophrenia that are closely related to intersubjectivity.
Communication and language, comprehensibility, and social isolation are all adequately
discussed in his theory. Today, Frith’s theory is still widely employed to study the symptoms and
signs of schizophrenia from a cognitive and neuropsychiatric perspective. However, the exact
role the ToM plays in schizophrenia remains somehow unclear, even within the cognitive debate
(Gerrans and McGeer 2003). It has been argued, for instance, that deficits in ToM are just a state
rather than a trait variable in schizophrenia (Corcoran et al. 1995). Others have argued instead
that it should be more than just a state, since patients not only display impairments in ToM with
regard to negative signs and during the chronic or residual phases of the disorder, but also in the
acute moments of psychosis (Brüne 2005, 35; Sarfati et al. 2000). Furthermore, any attempt to
summarize the cognitive neuropsychological theory of schizophrenia inevitably comes up
against the apparent lack of one unitary predominant theory capable of clarifying all symptoms
and signs. However, what Frith has succeeded in doing is to bring together all kinds of different
symptoms and signs, which were often considered to be very distinct. His work has therefore
proven very useful to clarify some of the symptoms, which had not yet been addressed by the
work of the other classic and phenomenological pathologists, or which have been provided a
different explanation by Frith. Besides the emphasis on cognition, Frith’s account focuses on the
intersubjective impairments and on the positive symptoms, which phenomenological
psychopathology sometimes seems to neglect. Within Bleuler’s and Minkowski’s accounts of
schizophrenia, for instance, exactly these positive symptoms and signs seemed to play only an
accessory role. Frith’s work has precisely the merit to suggest a fully alternative understanding
of these elements. As it will be shortly made clear, my hypothesis integrates these positive
symptoms as integral part of the intersubjective disturbance.

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 3.2 Manifestations of disturbed intersubjectivity in schizophrenia
In Chapter 2 I distinguished two main sections, corresponding to two forms of
intersubjectivity. One refers to intersubjectivity as experienced in encounters with others and it is
called mundane intersubjectivity.110 The others are here envisaged as directly experienced, or,
according to the transcendental terminology, they are there as constituted. The second kind of
intersubjectivity is instead found in the way we experience the world. We namely experience the
world as co-constituted. This second kind is referred to as transcendental intersubjectivity, and
others are experienced as co-constituting. I reiterate that distinction here in order to organize the
several phenomena, symptoms, and signs of schizophrenia into two groups. I will thus integrate
all elements outlined by the psychopathologists mentioned in the previous section into this
distinction. The idea is that this bipartition can efficiently organize the complex cluster of
symptoms and signs of schizophrenia, while at the same time relating it to intersubjectivity.
The first section will then cover symptoms related to the first kind of intersubjectivity, and
it involves difficulties and disturbances in the interpersonal sphere. The symptoms appear in the
in-between or in direct encounters with others. The second section will deal instead with
symptoms that involve the second kind of intersubjectivity, more specifically transcendental
intersubjectivity. This section will include especially delusions as disturbances of intersubjective
perception and intersubjective reality.

3.2.1 Encounters with others

Mundane intersubjectivity in schizophrenia
Based on the previous section of this chapter, two major forms of mundane
intersubjectivity can be distinguished in schizophrenia. The first group concerns how
schizophrenic patients encounter others in the shared world. The second group concerns instead
the types of intersubjectivity the patient experiences within the delusion. The main focus there is
on the role of others in delusions, on what kind of others are present, and what kind of
encounters can be described within the delusion. This does not yet amount to a study of
schizophrenic delusions from a transcendental perspective though, which will be instead carried
out in the second subsection. In this first subsection, only encounters, real or delusional, will be
discussed, the actual object of inquiry being how the experience of others changes for a
schizophrenic patient.

110
Recall that the terms ‘mundane’ and ‘transcendental intersubjectivity’ might sound ambiguous, as encounters
(mundane intersubjectivity) already require transcendental intersubjectivity, and the other way around.

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3.2.1.1 Encounters and intersubjectivity of the shared world
Concerning the encounter between the schizophrenic person and other people, three main
thematic areas can be outlined. The first concerns understanding others or empathy. Chapter 2
has explained how Husserl and his successors developed their respective accounts on
understanding others, and these very insights will be brought in as tools to clarify the
schizophrenic encounter. I will also discuss the famous ‘praecox feeling’ and Jaspers’ alleged
incomprehensibility here. Secondly, one more embodied aspect of encounters will be discussed.
The main question to be investigated is whether and how the attunement to others is altered and
what are the consequences of this alteration in the social sphere. Lastly, a full account of
schizophrenic autism and social withdrawal will be provided. It will be made clear here how the
patient experiences other people, and why social isolation often occurs.

Understanding others
Psychiatric diagnosis is hardly a matter of objectivity. The recent discussion on the new
diagnostic classification (DSM-5) again reveals the overall struggle to unify subjective and
objective elements of the diagnosis. Psychiatric illness is typically subjective on different levels:
the primary change as experienced by patients; their meaningful interpretation of these
experiences; the expression thereof to the clinician; the clinician’s interpretation; the experience,
knowledge, and background of the clinician; the particular cultural and social context; etc. All
these elements make psychiatric diagnosis inherently subjective. Some have argued that this is a
serious problem and that further attempts to objectify psychiatric diagnosis should be made, for
example by searching for biomarkers or by developing more diagnostic medical imagery. 111
However, most psychiatrists know that subjective components are essential to the diagnosis. A
good example thereof is given by Mario Maj in his critical analysis of the operational approach
to diagnosis: “We feel, or intuit, the existence of a basic relational deficit characterizing
schizophrenic patients” (Maj 1998). This describes nothing more than what Rümke originally
meant by ‘praecox feeling’ (Rümke 1960). The idea of a diagnosis based on the passive
recognition of a ‘Gestalt’ or a pattern, rather than on the listing of particular symptoms, was
often criticized as being arbitrary. It seemed indeed to imply that the doctor’s gut-feeling was
enough to account for a diagnosis (Phillips et al. 2012b).
This brief outline on the subjectivity element of psychiatric diagnosis is particularly
relevant, inasmuch as it hints at the importance of particularities in the direct encounter between
the patient and the clinician. It is true that the illness recognition is, partially, based on the

111
See for example the discussion by Insel et al. (2010) and Kapur et al. (2012).

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subjective feeling of the clinician, which still plays a role today, even though one might not call
it ‘praecox feeling’ anymore. Originally, the ‘praecox feeling’ referred to a lack of attunement
between the patient and the clinician. Rümke explains that it involves a lack of directedness and
affective attunement of the patient towards others and towards the world (Broome et al. 2013,
787). This lack of attunement is expressed in the appearance and behaviour of the patient, in his
physiognomy, expression, gesture, voice, posture, leading to a unitary impression (Fuchs 2013b,
617). Similarly, Kraepelin already noticed that a break in the affective relations with others was
often the first sign of the disorder (Kraepelin 1904, 182). Similar alterations have been widely
reported concerning schizophrenia. According to Walter von Baeyer (1955, 370), the encounter
with an autistic schizophrenic patient is “infinitely meagre, far and alien”. There is no real
contact with the schizophrenic. According to von Baeyer and the Dutch psychiatrist van den
Berg, one already notices this when shaking the patient’s hand. A schizophrenic patient only
offers the tips of their fingers, testifying of the distance in-between (von Baeyer 1955, 370).
Although these are hardly phenomenological, let alone empirical observations, I propose we
understand these accounts as attempts to express what these psychiatrists recognised as a
somewhat stable and persistent experience in the contact with schizophrenic patients. Both
Kraepelin and Bleuler already describe disturbed affective attunement. Bleuler even considers it
one of the fundamental symptoms. As previously mentioned, he claims: “One can often feel
much more connected with an idiot, who does not speak a word, than with a schizophrenic
person, who might still have his intelligence, but is affectively inaccessible” (Bleuler 1955, 377).
Jaspers (1948, 373) even calls the distance to a schizophrenic patient “an indescribable abyss”.
What is it exactly about these people that makes psychiatrists recognize them as “far and alien”?
It has been already pointed out that an essential part of our being-with-others consists of
understanding others as real persons. Husserl calls this empathy (Husserl 2012, 124). A viable
hypothesis could then be that this empathy is disturbed or not functioning as it is supposed to.
Empirical studies based on the theory of mind paradigm show that schizophrenic persons are
significantly below standard in recognizing facial expressions, attributing emotions to others, and
appreciating other people’s beliefs and emotions. In other words, schizophrenic patients are
thought to have difficulties in ‘reading the minds of others’ and in empathic perspective-taking
(Langdon et al. 2006).
With Chapter 2 in mind, and particularly with reference to Heidegger, a different view on
this matter can be formulated. One could argue that the encounter between a schizophrenic
person and the other, in most cases with the clinician, is an encounter without reciprocity. This
has nothing to do with the particular power relation between doctor and patient, but it is rather

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specific to the schizophrenic alteration. In normal encounters reciprocity is acknowledged and
experienced. As von Baeyer writes: “It is not the one-sided experience of an isolated individual,
but the lived relation with an independent opposite Other (Gegenüber), who can, on his turn,
encounter me or end the encounter” (von Baeyer 1955, 369). In schizophrenia, this reciprocity
might sometimes appear to be missing.
As previously outlined, Minkowski develops a diagnostic concept which is similar to
Rümke’s, namely the “diagnosis by penetration” (Minkowski 1966, 461). The idea is again
based on a subjective recognition in encounters with the patient. Just like Bleuler, Minkowski
reports primarily disturbed affective contact (Minkowski 1921, 255). However, he goes one step
further in order to clarify what this disruption of the affective relation could be. In one of his
most remarkable clinical descriptions, Minkowski explains his experience with a patient of his,
whom he had known for quite some time: “One day, when hearing him develop the same ideas, I
felt a particular feeling rising in me, a feeling that I would translate in these words: ‘I know
everything about him’” (Minkowski 1995, 165). The patient has nothing to hide, it is all out in
the open and there is nothing inaccessible about him. The clinician experiences, here, a rupture
in the usual affective relation.112
Karl Jaspers also points to an aspect of schizophrenia which involves similar face-to-face
contact. According to him, schizophrenic people are incomprehensible (Jaspers 1948, 486). I will
discuss the exact meaning of this statement and its relevance for our understanding of delusions
in the following subsection. As for now, it is important to remark that, according to Jaspers, in
the interaction with others what matters is not objectively ‘knowing’ what the other is thinking,
but rather the immediate grasping produced by the subjective relating to each other. In order to
understand (Verstehen), we firstly need some sort of connection with the other.
One specific aspect of incomprehensibility that can be already clarified concerns language.
Language helps us communicate. We are able to do so because we follow certain rules, like
grammar and syntax. We often adapt our language depending on who we talk to, such as a child,
a foreigner who does not master the language, or a colleague. As the ToM paradigm showed, we
assume a certain shared knowledge with those we talk to. Schizophrenic patients are however
often not able to correctly estimate the knowledge of others (Corcoran and Frith 1996; Brüne
2005; Wible 2012). This means that patients have a hard time to make themselves be understood.

112
Schizophrenia certainly involves affective disturbances, in the sense that psychotic experiences, anxiety,
depressive feelings, and isolation are often present. Recent empirical research on schizophrenia suggests a larger
role for affectivity in the evolution of the disorder and in the acute outbreaks of psychosis, also within
phenomenological psychopathology. On the role of affectivity, including stress, see (Myin-Germeys and van Os
2007). A phenomenological account on affectivity in schizophrenia is offered by Sass (2004)

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The specific linguistic signs like neologism, mutism, and chaotic speech, described by Kraepelin
(1904, 180) and Bleuler (1955, 345), and which contemporary empirical research is also
investigating (Covington et al. 2005; Stephane et al. 2007; Tan et al. 2014) are the manifestations
of such difficulties. Further studies have shown that linguistic disturbance in schizophrenic
patients is not a matter of language competence, of knowing words and understanding them. The
disturbance of language is, instead, specifically disturbed in the interaction with others. It is the
communication with others that is problematic (Wible 2012; Niznikiewicz et al. 2013). The same
framework can explain the ‘private language’ often developed by schizophrenic patients. Private
language arguably results from the divide between the common and the private world (Jaspers
1948, 243).
Frith’s interpretation takes up elements of incomprehensibility, in the sense that he
understands it as a disturbance of the patient to correctly or adequately interpret and respond to
the interlocutor, because of a disturbances of the meta-representation and self-monitoring. There
is, however, another side to this: the patient might also have difficulties in understanding the
others in general and thereby experience social contact as disturbing or even threatening. It
should be clear, nevertheless, that normal encounters are not supposed to be based on total
reciprocal understanding. Waldenfels argues, for instance, that inaccessibility and surprise
characterize the other, and they distinguish the other from an object: “The thing cannot relate to
me, it cannot answer or contradict me” (Waldenfels 1971, 138). The other, on the contrary,
answers, contradicts, and possibly surprises me. Stanghellini argues that this inaccessibility,
described by Jaspers in terms of ‘incomprehensibility’, should be understood as an ethical appeal
to clinicians “to navigate the infinite space that separates them from their patients” (Stanghellini
2013, 180). Normally, we are incapable of grasping, of completely understanding the other and
his mind, his intentions, or his experiences. We can, in fact, only approximate. Differently, with
Minkowski’s schizophrenic patient, everything is out in the open, restricted to delusional themes
and experiences. The unknowable and mysteriousness that define the otherness of the other is
lost. The patient seems robbed of any further profound affective life that could find resonance
within the clinician’s affective life.
It remains, however, difficult to fully define the immediate connection in the encounter,
and how this alters in schizophrenia. Based on Kimura’s ‘Aida’, it might very well be that
schizophrenia involves an alteration of the in-between, and that all the historical and
contemporary reports on this alteration, under the title of ‘praecox feeling’, ‘incomprehensibility’
or ‘je sais tout de lui’, actually try and express a radical change in the affective in-between.
Waldenfels describes the previously outlined in-between as follows: “It is found in the other, the

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self is found in the other, without need for a subject and object, a subject and co-subject to
separate primarily” (Waldenfels 1971, 236). Kimura and Waldenfels both advocate, then, an idea
of in-between as primary connection or unity before any distinction between subject and object
and subject and co-subject. Also the term ‘primary intersubjectivity’ coined by developmental
psychology (Trevarthen 1998; Fuchs 2015c) could well be taken as referring to a similar
primordial experience of unity, out of which the child develops during maturation and
individualisation, but which remains an ontological bond that we can still experience at times
through shared affectivity and ‘resonance’.113 One further element related to the understanding of
others clearly plays a role in the schizophrenic encounter with other people. These other people
might become less real to the patient, particularly in both acute and chronic psychotic states. The
others in the real world become anonymised, as von Baeyer explains. They lose their
particularities and their relevance, their own and shared history. In short, they lose their concrete
individuality (von Baeyer 1955, 371). The other, even the patient’s family, neighbours, or doctor
are not encountered as they are, but as functionaries in the delusion. They become the role they
have in the delusional system. In less severe cases, or in less acute times, the patient remains
connected to the shared reality and to others, while more severe patients indulge in their autistic
world and experience the other reality as a façade, with other people as mere masks (Bleuler
1955, 338). This derealisation of others might even evolve towards experiencing others as
objects (Fuchs 2015c). There is little affective connection and the other seems to play a very
minor role in regulating the experience of the world of the patient, as it will be made clear when
discussing transcendental intersubjectivity in delusions.

Attunement and intercorporeality

Merleau-Ponty is responsible for introducing the term ‘intercorporeality’ (Merleau-Ponty
1960, 167), his claim being that we are related to others through our embodiment. Does
schizophrenia also concern this intersubjective embodiment, or embodied intersubjectivity? In
addition, the reader is already familiar with the concept of attunement as the adjustment of one’s
experiences, behaviour, convictions, and attitudes to the situation and particularly to the social
situation. On the level of intercorporeality, this means that we are affectively related to the other.
We do not mirror the other’s affects, but we resonate, mostly passively, with these affects, and
reciprocally, the other resonates with mine. If I laugh, you laugh. But you do not laugh too much,

113
Recall how Stern described ‘core-relatedness’ as the condition for further development of a sense of self in
interaction and exchange with the environment. Any higher form of intersubjectivity would be based on this
prior relation between an emerging sense of self and the other (the mother) and otherness. Nevertheless, this does
not imply a primordial unity in the sense of an ‘adualistic confusion’.

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nor too little, not too fast and not too slow. If we were to exactly mirror affects or emotions, it
would feel artificial. We can easily tell when a smile is false, when an expression of sympathy is
dishonest. We ‘know’ this because we experience it immediately as not attuned. This does not
mean that we constantly adapt our affectivity to every single person we encounter, and, of
course, we always remain ourselves with our own concerns and emotional states. It might be the
case that we have a certain flexibility to attune our basic affective states to the surrounding world
and, particularly, to others. It is clear that this description of attunement on an embodied level
leaves a lot to clarify. This does not mean that this attunement does not exist though. It rather
expresses that embodied attunement is difficult to translate into language or into empirical and
measurable observational criteria. The embodied attunement is therefore pre-predicative, but it is
there in our experience of encounters.
Embodied attunement does not require inference or theory building. It is some kind of
immediate interaction, with little involvement of knowledge. The only knowledge we find is
some kind of knowing how. 114 It is the way in which someone acts and reacts which is
determining for the encounter. Within the framework of schizophrenia assessment, this knowing
how is called ‘common sense’. Blankenburg (1969; 1971) was indeed the first to highlight the
role of common sense,115 as he reported a young patient saying: “I was admitted to the clinic and
everyday—how all this took place in this space—I tried to absorb how others, as people,
behaved in front of me” (quoted in Blankenburg 2001, 308). In his article on the topic,
Blankenburg also writes: “What first emerges for many patients is a being unable to play along
with the rules of the game of interpersonal behaviour” (Blankenburg 2001, 306). According to
him, the question whether this involves a cognitive or an affective disturbance is irrelevant. This
question is taken as stemming from the incorrect assumption that these two faculties of the mind
are separable. “We find ourselves rather thrown up against what turns out to be a circular
structure. One is able to say that in the ability to judge, feeling has become the organ of
cognition. But even this formulation is not sufficient. Affectivity and the ability to judge, as we
find it in common sense, refer back to an original unity of thinking, feeling, and willing in
human existence, which is primarily related to an intersubjective world (mitweltbezogen)”
(Blankenburg 2001, 307). Common sense is then a form of attunement to the rules of the game,

114
Ryle (1945) introduced this term to distinguish it from knowing that.
115
Because of the multiple meanings of ‘common sense’, the reader will encounter this expression again
concerning transcendental intersubjectivity. First, as it is argued here, it helps to attune to a social situation and it
is a ‘felt’ knowing how to interact. Secondly, it will be used to designate a “network of beliefs” that is shared
with other members of the community, and consisting of the rules that determine how we act in a given situation.
For a brief discussion of ‘common sense’ and transcendental intersubjectivity, see (Wiggins et al. 2001).

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to the conventions of our shared life-world, in which we are rooted or anchored.116
Contrary to what one might think, what is at stake here is not just a matter of adapting to
social rules. As previously argued, also our simple perceptions are intersubjectively regulated,
for example in the determination of our categories of experience. On this lower and passive level
of experience, a disturbance in common sense entails difficulties to ‘feel’ or ‘sense’ what is
appropriate. In order to intersubjectively experience the world, we need a certain trust in others.
If this is missing, all explicit or implicit regulating attempts are in vain.
Despite its frequent references in phenomenological psychopathology, Blankenburg’s
concept of ’common sense’ remains open to varied interpretation. According to the perspective
developed by Frith and the theory of mind, common sense could be seen as based on the
possibility to take the position of the other, to anticipate what the other is experiencing, what
their intentions are, and what they expects from me. This interpretation neglects, however, the
embodied aspect of attunement and common sense, and it overemphasises the cognitive
component, which certainly should not be neglected, - as Blankenburg persuasively argues, - but
rather understood in connection to the experiential and affective aspect of common sense. One
could also argue with the late Merleau-Ponty (1960, 167) that our relation to the other is
necessarily attuned, as we are all part of the community of the flesh, of one sole
intercorporeality, even before the explicit acknowledgement of the other.117
As a result, affective resonance can be taken as the embodied aspect of the attunement to
others. According to Fuchs, this kind of resonance belongs to and originates in primary
intersubjectivity. He claims indeed that “this [i.e. primary intersubjectivity] is the basis of
empathy in face-to-face encounters: In embodied and empathic interaction, the other is not
assumed ‘behind’ his action, but he enacts and expresses his intentions in his conduct” (Fuchs
2015c). My body is affected in resonance with the affection of yours, and the other way around.
As already explained in the introduction, one aspect of the phenomenological analysis of
schizophrenia points precisely to disembodiment. 118 Disembodiment is not only a matter of
disturbed experiences of one’s own body, but it also implies a disconnection from

116
The ‘rules of the game’ are dynamic and they change according to changing social settings. Recall how
Minkowski understood the function of the rules, which I believe has a strong overlap with Wittgenstein (1969).
117
Merleau-Ponty’s description is a metaphor is used here to oppose Frith’s cognitive view, according to which
singular agents must undertake an effort in order to attune to each other and to common sense. As I have argued
in Chapter 2, I do not take Merleau-Ponty’s description as the only and correct way of defining intersubjectivity.
118
One could speculate on the two roles disembodiment has in this context. Firstly, it could be a cause for the
lack of attunement and the difficulties with common sense and with social interaction in general, as these are all
embodied in nature. Secondly, a primary disturbance of intersubjectivity in the form of intercorporeality could
imply that the person loses their embodied connection to others, which in its turn influences the embodied
experience and makes this person ‘disembodied’.

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intercorporeality. Being disconnected from or not part of the intercorporeal being described by
Merleau-Ponty, subsequently implies detachment and alienation, inasmuch as the patient cannot
immediately understand and recognise others through their embodied subjectivity, e.g. their
facial expression, gestures, and so on. Social interaction might as a result be reduced to explicit
attempts to theorize about the intentions of others, as outlined by the discussion of the theory of
mind. Blankenburg’s patient, Anne, described social encounters in a similar way: she had no
immediate understanding of how we act with each other, and it was as if each social encounter
would ‘lift her out of the saddle’ (Blankenburg 1971, 107).

Sociality
As the reader already knows, Bleuler considers ‘autism’ as one of the fundamental
symptoms of schizophrenia. As previously mentioned, the reference here is not to the
developmental disorder commonly known under that name.119 Autism for him rather means a
loss of reality by turning into one’s own phantasy world. Such a condition is described as
follows: “They live in an imagined world of wish fulfilment and ideas of persecution. But both
worlds can be real to the patients: sometimes both are consciously distinguished. In other cases
the autistic world is the only real world, while the other world is fake” (Bleuler 1955, 338). At
times, one of the two worlds comes to the foreground, and some patients are capable of
interchanging the world they experience. Minkowski later redefines schizophrenic autism as ‘the
loss of vital contact with reality’, as explained in the previous section of this chapter. Such a
condition involves the explicit detachment from the shared reality, both in delusional and non-
delusional states. Furthermore, one of the elements of the loss of vital contact with reality is
‘desynchronisiation’. Minkowski claims that schizophrenic patients have an altered temporal
experience. Fuchs also reports patients at different stages of schizophrenia, who develop
attitudes or ‘algorithms’ to compensate for a lack of what he calls ‘contemporality’ (Fuchs
2013d, 93). This can be understood, according to Minkowski’s terminology, as attempts at
resynchronization. 120 Accordingly, schizophrenic autism is defined mostly negatively as a
turning away from the shared world. Corin (1990) has argued, however, that schizophrenic
autism and the phenomenon of isolation are not necessarily ‘negative’, as they might result from
deliberate choices by the patient. Certain social interactions, for example, where only little real
contact is required, are often preferred over intense emotional encounters. The example of

119
Verhoeff (2013) explains the evolution from Bleuler’s autism to the concept as we know it today.
120
Intersubjective temporality was only briefly mentioned in Chapter 2. I refer the reader to Rodemeyer (2006),
Waldenfels (1971) and Fuchs (2006; 2007; 2013d), and to Chapter 4 where I describe the temporal component of
‘open subjectivity’.

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patients is provided, who might experience the superficial contact with shopkeepers or with
bartenders as more pleasant than the contact with family members. Some patients might also
make sure that the contact they have always remains restricted to this superficial level and that
further emotional interaction is easily avoided (Corin 1990). This suggests, according to Corin,
that patients actively work on the balance between distinction and connection. Every individual
actually has to find and develop such balance in social interaction, however schizophrenic
persons tend to shift balance towards distinction. As a result, the whole attitude towards the
world and towards others is altered. This active choice of deliberately limiting contact is what
she calls “positive withdrawal” (Corin and Lauzon 1994, 16).
Similarly, Stanghellini mentions young patients who express the need to differentiate
themselves, and more specifically, to distance themselves from common sense and the influence
of intersubjectivity: “It is common to find among persons vulnerable to schizophrenia and young
schizophrenics the rejection of attunement and intuitiveness, because these are considered
sources of conformity, inauthenticity, narrow-mindedness, loss of selfness, and of
differentiation” (Stanghellini 2001, 212). These young patients become frustratingly aware of the
influence others have on our individual activities, experiences, and subjective life in general.
They experience this as most unwelcome, possibly due to some kind of previous diminished self-
affection. Common sense can then even be considered as disturbing or threatening to one’s
ownness. The downside of these efforts at differentiation is unfortunately that the relation
between the categories of experience on the lower level of passive experience and the rules of
the game on the higher level becomes utterly idiosyncratic, therefore leading to isolation.
Frith understands social isolation as an essential component of negative symptoms.
According to him, these are not secondary to the primary dysfunction, but rather a crucial part of
the disorder. It would then be incorrect to claim that the negative signs are compensatory, as they
arguably often increase the decline in social and cognitive capacities more than the positive
symptoms do (Frith 1992, 42). It is, however, not unreasonable to assume that an altered
experience of others might lead to social isolation or to a change in social interaction, as Corin
has argued. An extra argument for this is that anhedonia, one of the negative symptoms, is
mostly interpersonal: it is a loss of interest in and pleasure with others (Wang et al. 2014). In
agreement with Corin, Brown et al. (2008) have found that isolation follows from social anxiety
and social anhedonia.121

121
See the review of De Wachter et al. (2016) on social dysfunctions in schizophrenia and the schizotypic
spectrum.

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 Along the same line, the description of the ego- or self-disturbances in schizophrenia
clearly outlines delusional experiences concerning primarily the experience of the other. The
other might be derealized, experienced as someone else, as an impostor. The other might also
become threatening. “The others’ gazes get penetrating, and it is as if there was a consciousness
of my person emerging around me … they can read me like in a book. Then I don’t know who I
am any more” (patient quoted in Fuchs 2000, 172). In the encounters with others, the self
appears to be perceived as fully permeable. Transitivism, first described by Bleuler, is a clear
example of the delusional experience of the weakening of the boundaries between self and other.
One of Stanghellini’s patients (2001, 210) noticed that this permeability is the most threatening
when she speaks with others. Isolation seems a logical answer to such threats.
Set aside schizophrenic autism and isolation, and focussing now on psychosis, hence
shifting from the negative signs to the positive symptoms, it is clear that these latter are often
defined as an extreme irrationality, in the form of perspectival rigidity, communicative
breakdown, and existential solitude. Parnas rightly claims that also these positive symptoms
should be reinterpreted in the light of a new paradigm, as they are primarily a “dislocation from
intersubjectivity” (Parnas 2013a, 213). Irrationality is arguably only one aspect of it. Minkowski
describes how schizophrenic patients seem to live in two worlds. The light one is the shared
world, however the patient can be in the dark world too, which is the morbid world with
disturbed distance and measure, in which the patient is completely alone (Minkowski 1995, 394).
Although hallucinations and delusions are only accessory symptoms of schizophrenia in
Minkowski’s view, he does note that they are expressions of “a brutal isolation” (Minkowski
1966, 15).
But is this true? Is there no intersubjectivity in the delusional reality? The other in the
shared world might become derealized and affectively disconnected from the patient, and the
concrete other might lose his subjectivity and ownness in the eyes of the schizophrenic patient.
In more severe cases the others might even become objectified, experienced as threats or
anonymized as characters in the delusional system. The absolute certainty of delusions might be
related to this, as we will see further on in the text. The real encounters with real others is thus
profoundly altered. The historical concepts, such as ‘praecox feeling’, are clear manifestations of
these interpersonal alterations. Now, it is worth taking a close look at the elements of
intersubjectivity within the delusion.

3.2.1.2 Encounters and intersubjectivity in the delusional world

In addition to the encounters with therapists, friends, family, and strangers, also other
forms of altered intersubjectivity can be accounted for. Schizophrenic patients with delusions

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may namely experience an additional sphere of intersubjectivity: the intersubjectivity proper to
the delusion. In this subsection I will go into details concerning how others are encountered in
the delusion and what kind of intersubjectivity this is. It might seem contradictory to first suggest
that schizophrenia is a disorder of intersubjectivity, and then propose an account of the
delusional reality as ‘containing’ intersubjectivity. It should be clear that the delusional
intersubjectivity is not ‘normal’ intersubjectivity. In Heidegger’s terminology, one can claim that
in the delusion the being-with itself is altered or absent. This does not mean that there are no
others in the delusion after all, just that the way in which we are with others is different.

Others within the delusion

Encounters with real others are often problematic and difficult for the schizophrenic
person. The isolation might not only result from the choice of the patient, but also from some
form of social exclusion. Blankenburg (1971, 49) suggests that the intersubjectivity of the
delusion is a compensatory reaction to social isolation in the real world. The others in the
delusion, he claims, could be thought of as a step towards “surrogate others”. However, a closer
look at the presence of others in the delusion, although undeniable, shows the limits of
Blankenburg’s position. This does not entail that others are unimportant in the delusion. On the
contrary, the content of schizophrenic delusions often involves others and most delusions can be
called ‘relational’.
An analysis of delusional leitmotifs (Stompe et al. 2003) shows that throughout the last
decades the concrete or superficial content of schizophrenic delusions has changed, often in
correlation to contemporary advances in technology, major historical events, and the like. A
patient today, for instance, feels less likely threatened by communist spies, and more likely by
Google and the NSA. However, what did not change are the underlying themes. The delusions of
most psychotic patients seem to concern the patient’s place in the social universe (Bentall et al.
1991). The best known delusions are paranoid delusions, and delusions of reference, and these
clearly involve others primarily (Frith 1992, 80). Walter von Baeyer (1955, 370) wonders why
there are “so few schizophrenic patients who are threatened by the rain, by the wind, while
almost all experience the indifferent gaze of the other on the street as directly aimed at
themselves”. What is essential to many delusional themes, just like themes of love and guilt, is
that they are relational. The other and the relation with the other is a major factor in the content
of delusions in schizophrenia.
But the fact that many delusions are relational does not necessarily mean that this is
surrogate intersubjectivity. The others we find in the delusional reality of the patients are hardly

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comparable to real others. These others are often superior and dominant, inaccessible, and
hidden or disguised (von Baeyer 1955). They are furthermore often representatives of groups or
they are primarily a collective, rather than an individual with a personality. The patient does not
encounter these others, but they are present in the world of objects: they send signals and become
manifest indirectly through objects in the world. Patients know they are being spied on, and the
patient’s phone, for instance, is perceived as a listening device. It is in these objects that the
others are present.
The relationship to the other in the delusion lacks mutuality and reciprocity. As von Baeyer
puts it: “It is pure being concerned, no responsivity, no exchange in being looked at, laughed at,
being commented and scoffed, being influenced, not the back and forth of a real encounter, but
only the one-sidedness of what we call self-referentiality” (von Baeyer 1955, 371). Everything is
directed at the patient, but there is no possibility to respond. The intersubjectivity in the delusion
is therefore not a ‘we’. It is not based on mutual understanding. “It is a characteristic of the
paranoid patient that there is no ‘We’ in his delusional sphere, no being-with others. Within the
delusional sphere, the paranoid person does not live with fellow humans (unter Mitmenschen),
but in opposition to them (unter Gegenüber-Menschen)” (von Baeyer 1955, 371). The others in
the delusions are therefore mere roles or functionaries in the larger delusional system.
So what kind of encounters do we find in the delusion? Can we even speak of encounters?
Arguably, the relational aspect of delusions does not entail any encounter. The others in the
delusions are mere expressions of the subjectivity of the patient. These others lack otherness,
they lack their own subjectivity, and they rather belong to the solipsistic sphere of the patient.
Interestingly, this kind of ‘others’ has certain similarities with the others in Husserl’s earliest
understanding of intersubjectivity, which was criticized for being solipsistic, as previously made
clear.
The intersubjectivity in the delusion is ultimately subjectified intersubjectivity. It is
intersubjectivity belonging to and originating in the subjectivity of the patient. The encounter in
the delusion is a pseudo-encounter. It lacks the dimension of the in-between. The accurately
called inter-subjective dimension cannot emerge in the delusion, because the patient already
enters this relation with self-centrality, making it one-sided and solipsistic.
In Chapter 2, Waldenfels’ dialogical phenomenology was introduced as maintaining that
we are related to each other through an indirect dialogue, and that we help each other attune to
one another and to come to the right relation with reality (Waldenfels 1971, 246). However, in
the delusion there is no such indirect dialogue. Earlier in this section, Waldenfels’ idea of
surprise was also reintroduced as a characteristic element of the other. However, the delusion-

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other is in his totality part of the delusional system of the schizophrenic patient, and therefore,
the delusion-other cannot surprise. Normally, the other exceeds and surprises us again and again.
“The other breaks the mould I make him” (Waldenfels 1971, 48). In the delusion, however, there
is nothing which surpasses the ‘property’ of the schizophrenic person.
Related to this loss of the potential of surprise that necessarily belongs to the other, is the
loss of contingency. Minkowski, for example, remarks that both contingency and surprise seems
absent in the delusion. Usually: “We are quite able to feel a pricking or see a spark without
relating these phenomena to a conversation that we are able to hear at the same time. We very
well conceive of isolated facts and objects whose simultaneous coexistence may be purely
contingent” (Minkowski 1970, 425). For a schizophrenic patient, instead, this coexistence may
not be so unproblematic, and “a mysterious force” (Minkowski 1995, 390) might seem hidden
behind the phenomena. The loss of contingency structures a world where essential parts of
reality are excluded, such as the possibility of chance, coincidence, meaninglessness, or the
unexpected. One of Fuchs’ patients reported persistent “events of duplicity” (Fuchs 2000, 142),
that were interpreted as signalling him something. One day, for instance, someone talked to the
patient about pistols, the next day a picture of a pistol was printed in the newspaper. The
meaning of this event of duplicity was clear to him: he had to shoot himself.
To summarize on the topic of encounters with others in the delusion, it should first of all be
mentioned that most schizophrenic delusions do involve relations to others. However, these
others lack individuality, they are mere representations of groups or collectives and serve a
specific purpose in the delusional system. The encounters themselves are sparse and the others
are mostly present indirectly in the objects of the world, signalling meanings to the patient. The
patient is central and all others are part of his solipsistic world. Interestingly, while the others in
the delusion are subjectified, the others in the real world seem to become objectified: they are
derealized, they have little influence on the perceptions of the intersubjective world, and they
become less relevant for the world of the patient. The fundamental alteration of intersubjectivity
to be emphasized here is twofold: within the delusion intersubjectivity is subjectified, whereas
the real others the patient encounters become objectified. In the next chapter, these two
alterations of intersubjectivity will be presented as belonging to the same essential disturbance,
as, so to speak, two sides of the same coin.

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3.2.2 Towards the world – with others
Transcendental intersubjectivity in schizophrenia
In Chapter 2, the concept of transcendental intersubjectivity has been defined as the
capacity to co-constitute reality. Here again, after accounting for the encounter between two or
more real human beings in schizophrenia, the focus shifts towards how these human beings
communally experience their world. Here again, this entails a shift in focus from a dyadic to a
triadic relation, namely between the subject, his peers, and their common reality. This part of the
text will focus on delusional phenomena, inasmuch as they are supposed to be deviations from
reality. 122 The purpose of this part of the text is to analyse normal and abnormal reality
experiences, and to clarify the delusional reality experience of schizophrenia. The idea is that an
analysis of this reality experience contributes to the understanding of the phenomenology of
delusions, i.e. the what-it-is-likeness of delusions. More importantly for this study, the factors
that play a role in reality experience and its deviations are to be accounted for in this section.
Thereby the role of intersubjectivity, and in particular, of transcendental intersubjectivity as
encountered in Chapter 2, is to be discussed here. Two main phenomena pertaining to
schizophrenia inform the discussion: the ‘primary delusional experience’ and ‘double book-
keeping’. The discussion of these phenomena paves the way to an elucidation of the factors
involved in reality experience, both in pathological and in non-pathological reality experience.
The method adopted in this analysis is phenomenological, and it could be specified as ‘radical
empathy’ (Ratcliffe 2012), ‘second order empathy’ (Stanghellini 2013), and ‘philosophical
understanding’ (Henriksen 2013). Radical empathy involves suspending the world that we “often
take for granted as a backdrop of interpretation” (Ratcliffe 2012, 491). It “directs attention
towards the ordinarily presupposed world” and it “involves incorporating such a stance into an
engagement with others’ experiences” (Ratcliffe 2012, 478). The phenomenological stance “can
be integrated into our attempts to engage with the experiences of others” (Ratcliffe 2012, 483).
The experiences of others can certainly differ from ours, but this difference implies challenge
rather than impossibility (Ratcliffe 2012, 474, 491). Double book-keeping and the primary
delusional experience are such phenomenological challenges, that we seem to be incapable of
spontaneous empathic understanding of them. An attempt at understanding these may indeed
have therapeutic significance, by searching a reconnection with others, who have lost connection
to the shared world (Ratcliffe 2012, 474).

122
An earlier version of this investigation of delusional phenomena has been published as (Van Duppen 2015).

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 This subsection will show how delusional phenomena are not just deviations from reality,
but disturbances in the shared relation towards the world, or transcendental intersubjectivity.
After discussing the two delusional phenomena, I will analyse which factors within the
experience determine their realness. As it will be made clear, intersubjectivity is one of the most
important factors in this context.

3.2.2.1 Double book-keeping and the primary delusional experience

Double book-keeping is a notorious concept which has been described by different
psychopathologists. At the end of the Nineteenth century, Kraepelin described a patient who
believed to be the “rex totius mundi”, but who would still humbly work in the hospital garden.
Another of his patients believed to be “God himself”, but continued to carry around firewood
(Kraepelin 1904, 260). After redefining Kreapelin’s dementia praecox into “the spectrum of the
schizophrenias”, Bleuler (1955) also deals with double book-keeping in various ways. In the
most extreme example he described a patient who had murdered his wife and child. During and
after the murder, he claimed to know that these were his wife and child, but at the same time he
also claimed to know that they were devils (Bleuler 1955, 340). According to Bleuler, some
patients, despite being aware of the incorrectness of their delusion, they hold on to it. Double
book-keeping, thus, involves a paradoxical double orientation on the one hand to the reality of
the delusion and on the other hand to normal reality. This is not only an intellectual stance of
delusional persons, but it is also manifested in the inadequacy of their behaviour. “The emperor
and the pope help to manure the fields; the queen of heaven irons the patients’ shirts and
besmears herself and the table with saliva” (Bleuler 1955, 344).
Louis Sass has revived interest into this phenomenon and described the paradoxical co-
existence of delusional convictions coupled with irony and distance towards these same
convictions (Sass 1994, 21). “The metaphor of double book-keeping implies the existence of two
distinct realms that, like an accountant’s two ledgers, are kept strictly apart” (Sass 2013a, 135).
The DSM-definition of delusions refers to erroneous beliefs that are firmly sustained, but it falls
short of describing the inconsistency and ambivalence of double book-keeping (American
Psychiatric Assocation 2013). Moreover, the phenomenon has generally proven to be particularly
challenging for certain analytical views and especially for those who claim that delusions are
indeed some form of beliefs (Bortolotti 2010). The paradoxical and inconsistent behaviour seems
indeed to contradict this view. Furthermore, Kapur’s neuropsychiatric approach neglects this
phenomenon in total (Kapur 2003). Jaspers himself pointed out three characteristic features of
delusions: absolute certainty, incorrigibility, and lack of correspondence with reality (Jaspers
1948, 80). These elements are taken into account by clinical views on delusions, particularly in

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the distinction between delusional-like ideas and real delusions (Spitzer 1989). However, this
definition of the delusion still does no justice to the complex phenomenon previously described.
The second delusional phenomenon discussed here is the primary delusional experience.
As I have discussed earlier in this chapter, Jaspers claims that the primary delusional experience
is the origin of the incomprehensibility of the real delusion (Jaspers 1948, 80). He claims that we
can neither empathically grasp this experience, nor do we understand genetically where it
originally emerges from. Patients notice a sudden change, which perplexes them, but they cannot
explain it: “Something is happening, please tell me what it is” (Jaspers 1948, 82). Jaspers further
explains that the varieties of primary delusional experiences present themselves in two main
forms. In the first, the patient experiences this uncanny feeling, where the atmosphere seems to
be changed in a particular way. Jaspers also calls this delusional mood (Wahnstimmung). The
patient searches for answers and clarification, since this experience is incomparable to any other
previous experience. Although it was argued earlier that patients are certain of the content of
their delusions, in this first form it is rather uncertainty and doubt that characterize the
experience. What is more, there seems to be no content yet to be certain about (Jaspers 1948,
82).123
The second main form of the primary delusional experiences contrasts with the first, as
both the content and the certainty of the content seem to be given right away (Jaspers 1948, 83).
The patient does not experience uncertainty or doubt, and he or she does not search for answers,
as they seem clear from the beginning. Klaus Conrad (1958, 88) calls this ‘apophany’ and it can
be compared to the religious experience of revelation (Henriksen and Parnas 2014, 545). Jaspers
remarks that it is possible that this second form emerges from the first, but that it is not
necessarily so. In other words, the second main form of primary delusional experiences can be
both the chronological consequence of the first, and an independent experience at the origin of a
real and possibly elaborated delusion (Jaspers 1948, 83).
The first form of the primary delusional experience clearly challenges the definition and
explanation of delusions from the outside. It should be remarked that the idea of delusions as
false beliefs seems to be contradicted by the uncertainty and doubt that, according to Jaspers,
precedes possible further elaborated delusions. The cognitivistic accounts of delusions seem
indeed to neglect this experience, and so, also neglect the original experience in which a delusion
might be embedded (Ratcliffe 2013, 231). On the other hand, at first sight, the neuropsychiatric

123
Other authors discuss the primary delusional experience differently. Hemmo Müller-Suur (1950) claims the
experience to be characterized by the “certain uncertainty”, while Klaus Conrad (1958, 83-87) described the
delusional mood as part of the “trema”, preceding the apophantic phase of the proper delusion.

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approach, already mentioned in this text, that is to say the dopamine hypothesis, might seem to
be better able to account for the primary delusional experience (Kendler and Campbell 2014).
According to this hypothesis, this experience is the consequence of dysregulation, and
specifically of aberrant salience of dopamine (Kapur 2003; Kendler and Campbell 2014).
By examining the problems of double book-keeping and the primary delusional
experience, one might be able to clarify the role of transcendental intersubjectivity in delusions.
It is worth, therefore, comparing the phenomenology of delusional experiences with variations of
reality experience in everyday life. Our experiences are seldom clearly categorized into the
groups of reality or unreality. We seem to experience different degrees of reality, sometimes
even simultaneously. One might discover other realities, for instance, when reading a book,
watching a play, or playing a videogame. These different realities sometimes even contradict
each other (Schütz 1945; Gallagher 2009, 254). A paradigmatic example of the variation in
reality experience concerns imagination. Phenomenological studies on imagination suitably
clarify those situations where a second reality is manifest, delusional or not. One of the
significant differences between delusional and imaginative reality should, however, be
emphasized: the imaginative reality is characterized by “ontic neutrality” (Fink 1966, 46-47;
Husserl 1976, 248; 2005, 691). When imagining an activity, for example, being a professional
football player and scoring an important goal, the real existence of this sportive activity is set
aside: it is neutralized. Whether the imagined content is actually true or false, you do not ascribe
reality to it, but rather remain neutral.
In a delusion, however, this neutrality seems to be lacking: the delusional world is real,
sometimes even more real than the shared reality. Both worlds can actually be experienced with
different degrees of reality, as we have seen with Bleuler. Contrary to the simple distinction of
reality in imagination, double book-keeping and ambivalence (Bleuler 1955, 338; Minkowski
1966, 97) suggest instead that a clear cut experience of reality is missing in the schizophrenic
perspective. Can these two ‘realities’ be simultaneously real? In other words, how can the patient
who is certain to be “the queen of heaven at the same time iron the other patients’ shirts and
besmear herself and the table with saliva” (Bleuler 1955, 344)?

3.2.2.2 Six factors of hypo- and hyperreality

What determines or influences these variations in reality experience? The terms hypo- and
hyperreality provide a useful description of the variations in reality experience. But what is
actually meant by these terms? Hyporeality involves the feeling of a certain degree of unrealness
to the experiences one has. This can concern both everyday and pathological experiences, and it
is not problematic per se. One could recall experiences of hyporeality, when in emotional shock

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after the sudden break up of a relationship, or after receiving news about the loss of a beloved. It
just does not seem real. If we fantasize, of course, we experience the fantasy as a hyporeality, or
even more, as an unreality. Interestingly, contemplating on the nature of our reality experience,
we may distance ourselves from our natural reality experience, and our experience might become
less real. In the clinical spectrum, such experiences are, for example, present as derealization in
certain depressions, or in cases of severe anxiety and panic attacks. 124 Delusional experiences, as
it will be discussed in detail further on, can also consist of hyporeality experiences. Hyperreality,
on the other hand, concerns those experiences that seem to have a higher degree of reality. They
seem more real than other experiences (Kusters 2014, 61). Crossing the gaze of another person
that one feels strongly for—whether it is because of love or hate—can be a hyperreal experience.
The intensity of the experience might make it stand out as more real in comparison to other
experiences that lack this intensity. It might be experienced as so real, that it strongly dominates
one’s thoughts and behaviour. Clinically, we can find examples in different delusional disorders,
such as the erotomanic or the jealous type, where a particular delusional content might be
hyperreal. As it will be made clear, hyperreality is a feature of the primary delusional
experiences.
In this section, I will discuss the six factors I believe to be involved in our experience of
reality and its deviations. This is not itself a deviation from the goal of this inquiry, but it offers
an indirect understanding of the role of intersubjectivity in the constitution of reality. This
discussion clarifies which factors can lead a person further into believing and being certain of the
delusional reality, or on the other hand, which (therapeutic) factors can increase the tendency
towards the shared world.125 The factors are, however, not constituents of reality, but they rather
describe what is in the experience itself that might influence its realness. Experiences of reality
are often made up of a combination of these factors, while some other factors may be absent. In
this analysis, each factor is illustrated with examples of clinical and non-clinical origin. It should
generally be remarked that these phenomena are indeed “not so far removed from everyday
experience as they might seem” (Ratcliffe 2013, 236). Thanks to the account of these factors, not

124
It would be a whole phenomenological study on its own to distinguish between the different kinds of
hyporeality, such as all the types of ‘derealisation’. The derealisation of others, such as family members or
caregivers who seem to be imposters or unreal in general, is something one can find in schizophrenic delusions,
but also in cases of dementia. This derealisation is phenomenologically different from the derealisation in states
of emotional stress and anxiety.
125
My approach in this subsection is inspired to the ‘Philosophy of Madness’ of the Dutch philosopher, Wouter
Kusters, who experienced two episodes of psychosis and wrote about these experiences. This part of the text
explicitly refers to Kusters' experiences and descriptions concerning hypo- and hyperreality (Kusters 2014, 59-
77). This approach also has some parallels in the work of Aggernaes (1972) on the quality of reality in
hallucinations. A recent adaption of his work can be found in Farkas (2014).

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only a new perspective on the two complex phenomena of double book-keeping and the primary
delusion experience will be outlined, but it will also be possible to systematically discuss the role
of transcendental intersubjectivity in schizophrenic delusions.

(1) Continuity
The first factor is continuity. Seeing a boat floating on a river is arguably much more real
than a sudden visual hallucination of a demonic face that pops up behind a window. However,
were this hallucination to accompany you for quite some time, the demon would become much
more real than the first time you saw it. Non-clinically, we are able to recognize a dream as
unreal because of the clear discontinuity between life while awake and while dreaming, and
because of the lack of continuity of experiences during the dream state itself. Although you
might see parallels, symbols, or elements taken out of your everyday life, you still recognize
them as unreal. Thus, continuity works in a twofold way: experiences that are bound together
with other experiences are more real, and real experiences present themselves gradually to us
(Kusters 2014, 67).126
Continuity as a factor of reality is not restricted to the experiential level, but also plays a
role on a biographical or ‘narrative’ level. Discontinuities on this level appear, for instance, when
moving out of the parental house, or after breakups of long lasting relationships with the related
emotional disclosure and social exposure. This biographical discontinuity is known to be a factor
in the first outbreak of psychosis (Fuchs 2010a, 566). Thus, also in this sense, discontinuity
seems related to disturbances of reality experience.

(2) Materiality and resistance

The second factor is materiality. When asked what reality is, we immediately and
somewhat naively point to the world of objects around us (Kusters 2014, 64). The chair you are
sitting on is real, the wall you are facing is real, your arms are real. Something material might
seem more real than something that lacks materiality. A book might seem more real than the
story in it, my writing more real than my thoughts. Thanks to Jaspers’ (1948, 79) and Schütz’s
accounts (1945, 546), it can be specified that what is real about materiality is its resistance. I can

126
One could also distinguish the realness of the given examples (seeing a boat, hallucinating a demon) based on
the noematic or noetic component. Seeing a boat is a perceptive act which will unlikely be grasped in its act-
character, while the noetic aspect of hallucinating a demon may be more shocking and real to us. Seeing a boat
lacks this noetic intensity, however the noematic aspect, the boat as perceived, offers more realness because of
the continuity of this perceptual object in relation to previous perceptions. We have seen the boat more than once
and its realness depends on a certain noematic habituality. I’m indebted to Thiemo Breyer for this remark.

162
act on something, I can grab something. The degree of reality depends on the resistance I
discover when performing the action.
The closer I am to objects of my actions and the less reflected I am about them, the more
resistance and realness I discover. My thoughts, on the other hand, are less real because they lack
this materialistic resistance. But then again, they do have a peculiar resistance, because I cannot
shape them exactly how I want without discovering some kind of resistance. Interestingly, the
phenomenon of hyperreflectivity, that has been described in phenomenological psychopathology
as one of the experiential core features of schizophrenia (Sass and Parnas 2003), illustrates this
negatively. A predominant reflective and distanced attitude disturbs the hold or grip on
perceptual reality (De Haan and Fuchs 2010).
The resistance of reality can also dissolve our imaginative worlds. “Reality is not only
what fills our imagination, but also that which may destroy it”, Wolfgang Blankenburg (1991b,
10) wrote, thus capturing the multiple roles that resistance can take in experience. Reality
imposes itself on our imagination with little resistance from the latter. A remarkable literary
example of this can be discovered in a novel by Austrian writer, Stefan Zweig, Der Widerstand
der Wirklichkeit (2009). In this novel Zweig describes the resistance of reality on the narrative
level. Two former lovers finally meet again after almost ten years. Not only the world has
changed, but they themselves have changed, and their hopes, imaginations, and memories
vanish, when confronted with the resistance of reality.

(3) Multiplicity of sensations and perceptions

With Husserl (1966a, 55) in mind, one could say that a variety of and a concordance
(Einstimmigkeit) among the different senses lead to the experience of something being real. The
fact that I see, feel and even hear (e.g. when dropping my fork, moving my plate,…) the table I
am eating on makes it more real than the food I assume to be around when I only recognize the
smell of it. Seeing, touching, and tasting the food makes it much more real than only smelling it.
Conversely, in a hallucination, a person might hear a voice, but he or she does not see, smell, or
feel the person talking to her. This might make the hallucination less real than the voice of a real
person. 127 Both Minkowski (1995, 388) and Frith (1992, 68) notice a different quality in the

127
This does not mean that in everyday experience, we always perceive according to all sensational modalities at
once. There are certainly times when we only hear, only see, or only feel someone or something that we
nevertheless hold to be real. One could indeed speak of “perceptual faith” (Merleau-Ponty 1968, 19). See factor
6 and the discussion on the interplay of these factors for further elaboration.

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reality of certain hallucinations, and the lack of multiple sensational modalities might be one of
the reasons.128
As recorded by Jaspers, a patient strives to gain reality by attempting to make use of
different senses: “All objects appear so new and unknown, that I pronounce the names of the
things I see. I touch them, to convince myself of their realness. I stamp on the ground, but still I
cannot experience the feeling of reality” (Jaspers 1948, 54).

(4) Intensity and affection

The quality of reality might be lower in certain hallucinations and delusions, defined as
hyporeality (Kusters 2014, 76-78). However, they may be hyperreal as well. What makes this
experience more real than others? The intensity of an experience could be another factor
influencing the dominance of either of the realities. As previously explained, crossing the gaze of
another person one feels strongly for can be an intense and hyperreal experience. One can even
feel physically affected. The gaze of the other may be enough to give up all doubts one might
have.
The delusional experience, in its turn, may be so intense, and the person can feel so
affected, or even overwhelmed, that they become immune to other experiences or arguments that
deny or contradict this first intense experience. The experiential horizon of the patient seems to
be restricted to the delusional reality. Thus, the intensity makes the delusional world more
powerful than any perception, as Kraepelin (1904, 178) rightly remarks. As a perfect illustration
of this a patient said about his own first psychosis: “The truths I found, presented themselves
immediately and directly with absolute certainty” (Kaplan 1964, 94).

(5) Independency and the sense of authorship

The phenomenological structure of imagination and multiple realities allows us to argue
that one more factor might lead to a change in reality experience. Namely, when the intentional
(imaginative) act, that constitutes the delusional reality, is not recognized as an activity of the
person. As we saw earlier, Fink and Husserl notice that imagination is characterized by ontic
neutrality, implying that the person who imagines is actually somehow aware of doing so.
Imagination, according to Husserl (2005, 656), involves an as-if or quasi-perception. When I
imagine the Pantheon, to take Sartre’s example (Sartre 2004, 88), I do imagine a structure with a

128
Another reason for the hyporeality of certain hallucinations could be the dysfunction of Victor von
Weizsäcker’s ‘Gestaltkreis’ (1950) that continuously couples actions and perceptions. This ‘Gestaltkreis’ is thus
more than the sum of a variety of perceptions and the possibility of acting on a materiality that offers resistance.

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colour, a location, and a shape, but I do not perceive it. I cannot count the columns, as I could do
if I perceived it. I quasi-perceive it then, I perceive it ‘as-if’ it were in my visual field.
The ‘as-if’ feature might be lost in the delusional reality (Fuchs 2013c, 252; Currie 2000),
and this latter may become a perceptual reality, rather than the consequence of an imaginative
act. The incapacity of the person to recognize that he or she is the active creator of the
imaginative world seems to correspond to the descriptions of a disturbance of the sense of
agency, as phenomenological psychopathologists have described in schizophrenia. Jaspers
(1948, 102, 484) did so at the beginning of the 20th century, and recently this sense of agency
has been studied more intensively (Gallagher 2000b).129 In this context, it can be understood as a
sense of authorship (Wegner and Wheatley 1999; Zahavi 2005, 6) concerning one’s own
imagination.
A remarkable pathological example of a disturbance in sensed authorship has been recently
described by Rosen Rasmussen and Parnas (2014). A young schizophrenic woman reported that
she had seen a movie inside her head while planning to go to the cinema. “Later that day, she
decided not to go to the cinema after all because the phantasy had left an unpleasant feeling that
it probably would not turn out nicely. Although, she knew ‘deep down’ that it was all just a
phantasy, ‘it felt like being there [in the cinema] in person’” (Rosen Rasmussen and Parnas 2014,
4). In agreement with the previous account of fifth factor, they write that the pre-reflective self-
awareness of the intentional act, what is referred to as the sense of authorship, is weakened. If
the person does not acknowledge (although implicitly) that he or she is the creator of this
imaginative or delusional world, this latter gains independence and reality.
A more common loss or weakening of the sense of authorship can also occur in everyday
life. We occasionally confabulate memories of events that did not really take place, or not the
way we remember them. To a lesser degree, this is an example of a non-clinical failure to
recognize one’s own imaginative act.

(6) Intersubjectivity
Back to the central topic of this text, one last factor of reality constitution calls upon the
complex role of intersubjectivity and its disturbances in schizophrenic delusions. These are
primarily the disturbances that involve the triadic relation between the patient, the others, and the
world. It is the shared relation towards the world that seems affected.

129
For an accurate discussion on the relation between the concept of the ‘ego disorder’ in early psychopathology
and the ‘self disorder’ in contemporary phenomenological psychopathology, see (Fuchs 2015a). A concise
recapitulation of the symptoms of disturbed self-experience in schizophrenia is given by Scharfetter (2003).

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 As previously argued, intersubjectivity is said to play a two-fold role. First, on the higher
order level of language and rules, the presence of others forms the community in which we agree
mostly implicitly on what is real and what is not. On this higher level reality is determined
according to rules and conventions. Although it does not look like an active process, as no single
subject is actively involved in setting the rules, it can be said to be active on the level of the
community. These rules change, as illustrated by the process of scientific evolution. What we
once believed to be true and what once influenced our individual lives, might change radically. 130
Both Husserl’s ideas (1973c, 133-142) on normality as the concordance among each other’s
experiences, and Waldenfels’s position (1971, 335) stressing on the conventional character of
our rules of experience come in handy in order to understand the disturbance of this higher level
within the context of delusions. The patient who believes to experience the frightening influence
of the Internet on his own thoughts would, on this higher level of intersubjectivity, be recognised
as ‘heterological’ in Husserl’s terminology. This means that most people are usually able to
notice that something is not right and their belief are not within the limits of what is allowed
within our community. In other words, one does not need to be psychiatrist to notice the
deviation from implicit conventions and rules. If this patient goes on to act differently as well,
other members of the community can again notice these different activities as they do not fit with
what is implicitly considered to be normal.
Secondly, on the lower level of reality experience, the presence of others is a condition for
the experience of reality. This lower level of experience involves passivity. Blankenburg suitably
describes the active and the passive poles of reality experience in these terms: “Life-world
relatedness (Lebensweltbezug) – as we understand it here – implies an open tension between
‘relating-to’ in the sense of using an active intentionality (active synthesis), and a more passive-
pathical (…) ‘always-already-related-to’. It is in the spectrum between these two poles that
reality is constructed. This means the constitution of something as something for someone (or of
someone as someone for someone)” (Blankenburg 1991b, 5). Such a phenomenological
distinction between the passive and the active level can actually prove to be beneficial to the
current investigation.
The passive level is first of all intersubjective because of ‘open intersubjectivity’, which is
just a different name for the influence of transcendental intersubjectivity on one’s own subjective
experience of the world. It is indeed the horizon of our experiences and it is based on the

130
Thomas Kuhn (1962) and Paul Feyerabend (1993) were the first to develop these ideas based on their
inquiries into the scientific process. The influence of scientific progress on our everyday beliefs is one of the
clearest examples of this higher layer of the intersubjective experience of reality.

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simultaneous apperception of what is not originally given. As previously explained, the crucial
turn in Husserl’s ideas on perception is precisely that this apperception is related to the possible
presence of others who could perceive the sides of an object that are not originally given to
me.131 It was also abundantly argued that intersubjectivity is a transcendental condition for the
experience of reality and objectivity. The sharing of the world is a necessary condition for
“perceptual faith” (Merleau-Ponty 1968, 19), for a stable experience of the reality of our
perception. In the earlier mentioned example of dreaming, it is not only the discontinuity that
allows you to recognize the unreality of the dream after you have woken up, but also the absence
of other perspectives (Schütz 1945, 563). It is clear that a disturbance of intersubjectivity, of
being with others, of recognising others as co-constituting and co-experiencing in the world,
disturbs the function of Husserl’s open intersubjectivity. If one were to follow Husserl on this,
then it would be correct to argue that disturbed intersubjectivity necessarily leads to a changed
experience of the world.132
Furthermore, also perceptual anomalies in schizophrenia can be better understood as a
disturbance of open intersubjectivity or transcendental intersubjectivity. Not only particular
forms of derealisation, including the derealisation of real other people, but also the alterations in
the perception of objects can be suitably explained within this framework. The famous
‘delusional perception’ described by Jaspers and Schneider is a good example of this. 133 A
schizophrenic patient immediately sees an object as a particular element of the delusion. His
phone is not perceived as his phone, but as a listening device. The face of a random pedestrian is
directly perceived as a warning for the soon to come apocalypse. Also the perceptual
fragmentation often found in patients’ self-reports can be easily related to a dysfunction of open
intersubjectivity. “She remembered that she could not look at the whole door. She could only
look at the knob or some corner of the door. The wall was fragmented into parts” and “I may
look at the garden, but I don’t see it as I normally do. I can only concentrate on details. For
instance, I can lose myself in looking at a bird on a branch, but then I don’t see anything else”

131
Blankenburg (1991b, 16-19) discussed the role of perspectivity in delusions. He argued that delusions are not
just expressions of ‘aspect-sclerosis’ as previous psychopathologists had suggested. We arguably need more than
perspectival flexibility to experience reality. The limitations or boundaries of our perspectival shifts equally
contribute to the experience of reality. See Breyer (2014) for further elaboration of these ideas.
132
I will return to this consequence, as it is not unproblematic. One can, for example, argue that schizophrenic
delusional patients still perceive normally, and only focal elements of their experiential field have altered.
Furthermore it needs to be clarified what a disturbance of intersubjectivity would be and whether disturbed
reality experience is really a consequence or a secondary effect, rather than a primary cause.
133
Contrary to Jaspers, Schneider thought that delusional perception was based on false interpretation or on an
addition of meaning to a normal perception. The critique of his idea of a meaningless perception as well as the
critique of the distinction between perception and meaning in general are summarized in Spitzer (1989, 24-31).
A phenomenological analysis of the concept is provided by Fuchs (2005b).

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(patient 1 and 2 in Uhlhaas and Mishara 2007, 143-144).134
A disturbance of open intersubjectivity clearly entails the alteration of the integrity of
perception and, based on Husserl’s ideas on apperception, this can be easily explained.
Accordingly, also the meaning and utility of objects in a common sense context are altered, As
these meanings and utilities of perceptual objects depend on the prior integrity of perception. If
the integrity is lost, as the patients above described, these objects also lose their meaning, or their
‘affordances’ (Uhlhaas and Mishara 2007, 145).135
The same level of passivity also accounts for ‘fundamental certainty’, ‘basic trust’, and
‘perceptual faith’. These descriptions indicate that we have a particular certainty in our
experiences, even in experiences of doubt. This fundamental certainty or trust concerns “our
direct, pre-reflective and practical grasp of the world” (Rhodes and Gipps 2008, 298).136 These
bedrock certainties emerge from our everyday experience of the world, which is not an isolated
experience, inasmuch as we share our engagement in the world with others, as clearly explained
by both Heidegger (1967, 125) and Waldenfels (1971, 136, 246). Trust is acquired through the
interaction with others, through the regulation of my experiences in attunement with others.
Building on this practical engagement, I integrate the bedrock certainties of my community. This
means that a belief or conviction I might carry is always related to the intersubjective context.
Clearly, I mostly do not ask whether others agree with my ideas, but I have integrated the
intersubjective validation in order to know even before asking whether this idea or belief is
correct. In a delusion, the absolute certainty that might be present at times can instead be
understood as a disturbance of this intersubjective trust. It remains a trust or a certainty, but is
not intersubjectively confirmed, nor is it attuned or open to modulation or regulation. It is as if
the delusional person has excommunicated all others from his immanence. This entails that the
patient becomes solipsistic, and the others are degraded to objects or side figures in a play.
Spitzer’s definition of schizophrenic delusion can be now useful, as it points out that the delusion
has the form of a statement about one’s most personal mental states, but its content concerns the
intersubjectively accessible world (Spitzer 1989, 115). The patient does not recognize what is
private and what is shared, what is self and what is other. However, according to Husserl, in
order to experience intersubjectivity I have to recognise my own original sphere
(Eigenheitssphäre) as well as the intersubjective sphere. In his own words: “I distinguish

134
I would not claim that this fragmentation is only due to dysfunctions in intersubjectivity. It has been equally
argued that fragmentation is the result of a disturbance of the protentional function of inner time consciousness
and the ‘intentional arc’ (Fuchs 2007).
135
Recall Bleuler’s description of ‘Begriffsverschiebung’ or ‘shift of meaning’ (Bleuler 1955, 332).
136
The fundamental certainty, the basic trust, and the perceptual faith described by the phenomenologists in
Chapter 2 all come close to Wittgenstein’s descriptions (Wittgenstein 1969, §88, §341, §342).

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between a) that which I find in my self, independent of others, in my own intentional field as
worldly and as the world itself, and b) that, which I find with the ‘help of others’, being the
objective world that is there for all of us” (Husserl 1973b, 385). Accordingly the phenomenology
of intersubjectivity claims that even the highly personal is permeated by the intersubjective, e.g.
through the categories of our experience. Differently, Spitzer’s definition points to the fact that
some patients happen to rely on the kind of certainty that is only found in a fully solipsistic
universe, that is to say in their own immanence from which others are banned.
All in all, delusions can be defined as disturbances of the intersubjective experience of
reality. This means firstly that the attunement with and regulation by others on the highest level
of reality experience is dysfunctional. Secondly, it means that the lower level of passivity is
disturbed: where we normally attune our trust and certainty pre-predicatively to the community
and therefore experience the world as real, the absolute certainty of a schizophrenic delusion
shows a disengagement or a disconnection from others. The certainty is a solipsistic certainty.
Lastly, it means that intersubjectivity cannot play its transcendental role in perception, which
Husserl called open intersubjectivity. These elements are all implicitly present in Spitzer’s
definition.
What about the content of delusions? It has been argued in the previous subsection on the
encounter in the delusion that schizophrenic delusions are often relational. This means that the
underlying themes involve others and the role they play for the patient. Delusions of persecution
are best known. The patient is abused or threatened by a collective of evil people, or persecuted
by a strange authority. But also more bodily experiences like transitivism, the feeling of
permeability, and passivity experiences relate to how others directly threaten and influence the
patient (Bleuler 1955, 338). Furthermore, Blankenburg claims that delusions are not just a matter
of a loss of perspectival flexibility (Aspekt-Sklerose). The absolute certainty, together with the
lack of attunement to others and their regulations certainly imply that the schizophrenic
delusional patient does not try to see from the perspective of the other and remains self-centered.
Conversely, there are also experiences in schizophrenia that consists of too much perspectival
flexibility, where patients describe a lack of personal perspective.
In agreement with the perspective outlined so far, Kusters (2014, 551) remarks that the
psychotic self essentially loses connection and attunement with others and their stable reality. As
previously made clear, this is exactly what Minkowski (1927, 5, 236, 250) defines as the ‘loss of
vital contact with reality’. A disturbance of intersubjective reality urges the constitution of a
new, idiosyncratic reality (Schwartz et al. 2005; Fuchs 2015c). A delusional reality, however,
without the characteristics of self-evidence and attunement to others.

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 To conclude this paragraph on the role of intersubjectivity in schizophrenic delusions, I
think it is vital to point to the intertwining of transcendental and mundane intersubjectivity. The
same circularity discussed at the end of Chapter 2 returns here: the mundane determines the
transcendental, just as the transcendental shapes the mundane. In other words, I adopt the
bedrock certainties of my community, based on my practical engagement in the world with
others. Mundane intersubjectivity together with concretely social interaction offer the ground for
the process of world-constitution through categories, forms of thinking and sensing. As a person,
I am with-others, and these others influence and regulate my individual experiences. One
example thereof is the regulation of reality experience. If children talk about dreams they had,
we assure them that it was just a dream, and not reality. Children then integrate this regulation
and thereby evaluate their own experiences differently. The same regulation of reality happens,
often in an ‘indirect dialogue’, rather than explicitly, once we are mature. This means that
mundane intersubjectivity influences my individual constitution of experience. However, it does
not end there, as the transcendental level ‘forms’ the mundane.137
If we conclude that in schizophrenic delusions, a particular alteration or disturbance of
transcendental intersubjectivity is present, then this should be expressed on the other level,
namely the mundane level of the shared world. Clearly, this is the case: delusions are defined by
their predicative character, that is, they are incorrect or even incorrigible statements and
judgements about the world. But we have seen that this is not the only manifestation of an
alteration to transcendental intersubjectivity. “Crazy activities” (Conrad 1958; Parnas 2013b) are
further manifestations of how the transcendental constitution of reality experience is disturbed.138
The indirect dialogue with others, the shared engagement that defines our being-with, and our
enacted intersubjectivity are then altered.

Understanding the two phenomena

I started the analysis in this subsection with the two complex delusional phenomena. Now,
we are better able to understand them and their significance to grasp the role of intersubjectivity
in schizophrenic delusions. First of all, double book-keeping, the related ambivalence, and

137
As I have explained in Chapter 2, the intertwining of the empirical and the transcendental prevents us from
interpreting this sentence idealistically.
138
Conrad described how subtle changes in behaviour and decisions might illustrate the beginning of psychosis.
According to the current investigation, these changes illustrate a loosening of the connection to the
intersubjective reality. Conrad described, for example, how during the occupation of Paris, a German sergeant
led his troops to visit the cultural highlights of the city, to show them the magnificence of the enemy. This would
not be considered psychotic, but his immediate surrounding considered it ‘crazy’, as it disturbed the actual
context.

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possible distanced attitude of delusional patients towards their own convictions and beliefs can
be better qualified in the light of these six factors. One factual example suitably serves this
purpose. The interplay of multiple factors can be said to form the paradoxical co-existence of
supposed excluding realities. A patient experiences a frightening influence of the Internet on his
own thoughts (Stompe et al. 2003). This experience is so intense (factor 4) that it seems
hyperreal, and the factors that contradict the reality of this experience are neglected, such as the
discontinuity (factor 1) and the lack of multiple sensational modalities (factor 3). However,
confronted with family or caregivers who try to reassure the patient, his original experiences of
being influenced may start to seem doubtful and less real. The lack of intersubjective
confirmation (factor 6) of his experiences may in a way neutralize their realness. However, if
these experiences remain, they gain continuity (factor 1) and are taken to be increasingly real.
Furthermore, the patient may not recognize his own imagination at work, what was defined as
sense of authorship, but instead experiences what happens to him passively (factor 5). The
patient may learn that others do not believe him and categorize his experiences as phantasms or
as psychopathology. He may thus talk about these experiences with distance and somehow
acknowledge that these are private experiences that are only real to him, but real nonetheless.
These factors help us to understand that double book-keeping is a way of integrating highly
intense, unsettling, and sometimes meaningful experiences into one’s life, particularly when
these experiences do not fit or even break previous coherence and continuity. Double book-
keeping seems to indicate that a person can be ‘inside’ or ‘outside’ of a particular compartment
of experience that is highly idiosyncratic, private, and lacking intersubjective validation.139
Secondly, both main forms of the primary delusional experience, as Jaspers describes
them, can be better understood in reference to the above listed factors. The patient, who suddenly
discovers that the colours of passing cars seem to signify something important to her, and for
whom the number plates carried unclear messages, is markedly affected by hyperreal insights
(factor 4). The discovery of being at the centre of all these symbols is perplexing, and it shook
her with an unknown intensity. However, when confronted with the disbelief of her husband
(factor 6), and later on, during psycho-education, with the health care workers explaining her

139
Double book-keeping certainly deserves more study than I can offer in this chapter. One of the questions is
how the patients experience these two realities themselves. Sometimes patients realize the contradiction and this
may become embarrassing. Another point would be to compare the delusional reality to other private
compartments of experience, like those needed for artistic creativity. Such ‘compartments’ are, I would suggest,
not intersubjectively accessible either, but the difference would consists in their experiential realness. Thanks to
Thomas Fuchs for remarking this.

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that it was the consequence of her own neurotransmitter dysregulation (factor 5)140, rather than an
independent reality, she turns doubtful on her previous insights.
To take another example, consider a person who felt touched by the light of God in a
moment of heavenly clarity. The clear contents and answers she receives may arise with an
overwhelming intensity and affection, thus becoming hyperreal. In this case this dominates all
other contradicting factors, such as discontinuity (factor 1), lack of resistance and materiality
(factor 2), and the lack of intersubjective confirmation (factor 6). There are also enough
examples of similar experiences that are intersubjectively embedded, for example in a religious
context. In these cases, the intersubjective confirmation may allow and support such experiences
to function in a meaningful way, without being considered pathological (Hunt 2000). With the
interplay of these factors in mind, both the doubt and uncertainty that characterize the first main
form, and also the immediate certainty of the second main group become more accessible and
understandable. The previous analysis of intersubjectivity can be further employed in order to
clarify how the primary delusional experience first emerges as “a puzzling, mysterious and
stage-like scenery” (Fuchs 2005b, 133). Although I’m well aware of the speculative nature of
such a claim, I would indeed argue that a primary disturbance of intersubjectivity could well be
the cause of such experience. If open intersubjectivity breaks down, the patient cannot but
experience differently, as the necessary condition for apperception is lost. Furthermore, without
the continuous integration of the intersubjective categories of experience and without
experiencing others in such a way that they contribute to the experience of reality and
objectivity, it is no wonder that the experiential life may become idiosyncratic, and certain
situations become perceived as self-referential (Fuchs 2005b). Concretely, a disturbance of
(transcendental) intersubjectivity can lead to alterations of perception itself, of the immediate
perceived affordances of objects in the world, of the meanings they have, as well as to altered
realness of an experience. The patient who recognizes special messages in the number plates of
cars may be understood as suffering from a breakdown of transcendental intersubjectivity. This
leads, just like in a fully developed delusion, to an idiosyncratic apprehension of the world. This,
in its turn, may allow ‘realities’ or ‘truths’ to appear that lack intersubjective confirmation,
habituality, or embeddedness, and thereby, appear with a completely different intensity. Such
intense or hyperreal experiences may then be the basis for the development or crystallisation of
full-blown delusions.

140
Whether this is an adequate and helpful procedure for a (recovering) delusional patient is something I cannot
discuss in this chapter. I will return to the issue of recovery in Chapter 4.

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 Conclusions
In this chapter I have examined the intersubjective dimensions of schizophrenia. The first
part of the chapter provided a conceptual analysis of the works of psychopathologists who
contributed to the understanding of the disorder. The purpose of this part was to investigate
whether disturbances of intersubjectivity are present in the different theories on schizophrenia,
and if so, what kind of disturbances. From the first descriptions by Kraepelin until the most
recent account based on the ToM paradigm, a variety of symptoms, signs, and phenomena were
mentioned that show the importance of intersubjectivity in schizophrenia. Whereas the self-
disorder model strongly relies on the accounts of the classic and phenomenological authors, it is
now fair to claim that this model of schizophrenia could benefit from widening its scope towards
intersubjectivity. This analysis has shown that a phenomenological account of schizophrenia
should integrate these intersubjective dimensions.
The second section of this chapter was devoted to the manifestations of disturbed
intersubjectivity. I reiterated the distinction between two kinds of intersubjectivity. The first
subsection concerned the encounters with others. First of all, three domains of the encounter with
others showed clear manifestations of an altered intersubjectivity. These involve understanding
others, attunement and intercorporeality, and sociality. Patients are explicitly reported to have
difficulties with understanding others and making themselves understood. Jaspers’ famous
definition of schizophrenia and particularly schizophrenic delusions as ‘incomprehensible’
grasps one aspect of this; another aspect points to Rümke’s ‘praecox feeling’. Patients seem to
become inaccessible and attempts to reconnect with the patient are characterized by a lack of
reciprocity. The examples provided by Jaspers, Rümke, von Baeyer, and Minkowski all point to
the same phenomenon of disconnection from the other. This disturbance of understanding others
and being understood is said to include both an affective as well as a cognitive aspect. The first
pertains to ‘feeling’, it is a subjective phenomenon in the encounter with the patient. Kimura’s
‘in-between’ offers an adequate term to describe the ‘felt’ bond with the other that is
nevertheless open to distinction, separation, and individualization. The second is most noticeable
in the variety of language disturbances, which are claimed to reflect a primary communicative
disturbance rather than a real linguistic dysfunction.
Secondly, attunement and intercorporeality in schizophrenia have been given due attention.
The schizophrenic person may experience difficulties to become aware of the implicit rules that

173
form the common sense of social interaction.141 Other patients are aware of these rules, but fail
to integrate them into their own activities or experiences. They do not ‘feel’ or ‘sense’ what is
appropriate and cannot attune adequately to the surrounding. The trust that develops from
interactions with others is, I believe, a determining factor in the difficulties recorded concerning
common sense, precisely because attunement is not a matter of intellectual or rational efforts. In
order to experience the intersubjective world, we need a certain trust in others. If not, our explicit
or implicit regulating attempts would be in vain. The ToM paradigm highlights the cognitive
aspect of this difficulty, namely the shift of perspectives, but it fails to account for the immediate
and embodied part, which I have discussed as ‘affective resonance’. This has little to do with
explicit perspective taking or with social reflection.
One last domain entailing intersubjective disturbances in encounters concerns sociality,
and it includes autism and withdrawal. While Bleuler defines schizophrenic autism as living in
phantasy worlds, Minkowski would redefine it as a loss of vital contact with reality.
Minkowski’s work also provided useful insight concerning desynchronisation as an example of
temporal disturbance involved in schizophrenia. More recent ideas on schizophrenic autism
emphasise the voluntary side of it, where patients actively avoid social life with its confrontation
and difficulties. Some patients even rationalise their social withdrawal by describing the
threatening influence of sociality on their already weak feeling of individuality. One last aspect
of schizophrenic autism entails alterations in the experience of others, namely when others
become derealized or (in psychotic phases) imposters or functionaries of the delusional system.
Besides these three domains concerning the encounter with others, I also proposed to include
another kind of intersubjectivity, namely the intersubjectivity within the delusion. Although I do
not claim that this is intersubjectivity in the usual sense, it does relate to how the patient
experience others, even though these others are not ‘real’ others. Most schizophrenic delusions
involve relations to others. However, these others lack individuality, they are mere
representations of groups or collectives and serve a purpose in the delusional system. The
encounters themselves are sparse and the others are mostly present indirectly in the objects of the
world, signalling specific meanings to the patient. The patient is central and all others are part of
his solipsistic world. While the others in the delusion are subjectified, the others in the real world
seem to become objectified: they can be derealized, they have little influence on the perceptions

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Here, I refer to common sense as the felt connection necessary for attunement to and understanding of social
situations. It is some kind of knowing how, as previously claimed. Again, this should be distinguished from the
“stock of knowledge-at-hand useful at the level of everyday life” (Stanghellini 2001, 205). This second kind of
common sense involves a “network of beliefs” that is shared with other members of the community. Common
sense is thus a concept useful for both the mundane and the transcendental disturbances of schizophrenia.

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of the intersubjective world, and they become increasingly less relevant for the world of the
patient. The fundamental alteration of intersubjectivity in delusions is twofold: within the
delusion intersubjectivity is subjectified, while the real others the patient encounters become
objectified.

Mundane intersubjectivity

Understanding others
Encounters:
‘objectified intersubjectivity’
Attunement and intercorporeality
Sociality
Within the delusion: ‘subjectified
intersubjectivity’ Self-other structure

Table 1. An overview of the key alterations to the encounter in schizophrenia as analysed in subsection 3.2.1.

The second subsection provided an overview of the manifestations of disturbed

intersubjectivity in the shared world and it accounted for transcendental intersubjectivity in
delusions. I have argued in favour of a phenomenological understanding of two complex
delusional phenomena, namely double book-keeping and the primary delusional experience. This
did not only offer a wider understanding of these phenomena, it also led us to conclude which
factors play a role in the experience of reality. For our purpose the last factor was the most
important, namely the role of intersubjectivity in delusions. I discussed both the higher level of
convention and implicit rules that determine how we actively experience and constitute reality,
and a lower level of passive reality constitution. I argued here with reference to the discussion in
Chapter 2 that schizophrenic delusions involve alterations or disturbances of transcendental
intersubjectivity.
First of all, delusions are deviations from normality and they show disturbances of what
Husserl called ‘orthological’ experience. It is a kind of experiencing that is not attuned to the
experience of others. Besides this experiential normality, delusions show a disturbance of
conventionality, namely of the explicit and implicit rules that determine our activities and
behaviour, what Blankenburg calls ‘common sense’. This becomes clear in the ‘crazy activities’
schizophrenic patients are sometimes credited with. Thirdly, it was possible to account for the
patients’ altered perception: not only the meaning of an object and its affordances can be altered,
but also the perceptual object itself. The patient may, for example, perceive his phone to be a
listening device, as an example of different meaning, but other patients described how they are

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unable to perceive an object as a whole, leading to fragmentation of their perceptions. In the light
of Husserl’s concept of ‘open intersubjectivity’ we can understand transcendentally why such an
experience would be possible. If a subject perceives an object without the function of open
intersubjectivity and thus without the possibility of apperception, the subject can only perceive
what is actually given to him. Again, based on Husserl’s idea of reality, it is clear why patients
can experience derealisation of objects and others.
Furthermore, we unravelled the absolute certainty of the delusion as a certainty unlike any
other. It is immanent or solipsistic certainty, and it lacks openness to correction, modulation, and
doubt. I followed Spitzer’s description of this certainty as having the apodicticity of the
subjective (or immanent) world, but concerning the ‘external’ or intersubjective world. This
definition grasps how the usual configuration of immanent and personal with the intersubjective
and social is disrupted. What is mine and what is other are mixed up. The fluid borders between
self and otherness are therefore not only a feature of the phenomenon of transitivism, but can
also be found in the delusional conviction.
Turning from the investigation of the form of delusions to their content, we saw that most
schizophrenic delusions are relational and concern the reciprocal influencing of self and other.
This is clear in paranoia, in the threatening presence of others, and in the disruptions of the self-
other demarcation.
The investigation has led us to conclude that schizophrenic delusions are clear
manifestations of a disturbance in the intersubjective experience of reality. The schizophrenic
delusion manifests a particular alteration in intersubjectivity on the active and passive levels of
experience, as well as in the domain of behaviour, attunement, and interaction. Together with the
analysis of the encounters with others, this suggests that the schizophrenic alteration originates in
the intersubjective constitution of this pre-reflective, pre-predicative life-world. It became clear
that the role of intersubjectivity in schizophrenia can only be clarified by paying attention to both
the transcendental and the mundane aspect, which I have tried to do in this and the previous
chapter.

Transcendental intersubjectivity
Active or higher level Normativity and conventionality

Passive or lower level Open intersubjectivity

Categories of intentionality
Reality and objectivity
Perceptual faith
Table 2. Overview of the key alterations to the co-constitution of reality as analysed in subsection 3.2.2.

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 This chapter offered the clinical and conceptual elements relevant to describe the
intersubjective dimension of schizophrenia. It can finally be concluded that schizophrenia indeed
involves a particular alteration of intersubjectivity. It affects both mundane and transcendental
intersubjectivity, and the patient manifests these changes both in relation to others, as well as
towards the shared world. A first attempt to conceptualize the exact nature of this intersubjective
disturbance, to find the ‘trouble générateur’ so to speak, would be to define it as a disturbance of
‘open subjectivity’. The exact meaning of this definition will be discussed in Chapter 4. Now
that this chapter has proven the intersubjective nature of many manifestations of schizophrenia,
this knowledge can be combined with the philosophical insights from Chapter 2 in order to
discuss the relation between self and intersubjectivity disturbances.

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 CHAPTER 4. PSYCHOPATHOLOGY AND
PHILOSOPHY OF INTERSUBJECTIVITY
In this chapter I aim to provide an answer to this inquiry’s main research questions. I
start by confirming the first question: Is schizophrenia an intersubjectivity disorder? Since I
have taken a phenomenological perspective on schizophrenia, this research requires me to
account for the relation between my description of the illness as a disorder of intersubjectivity
and the phenomenological description of schizophrenia as a self-disorder. In particular, the
question is whether this relation is foundational, i.e. whether the disorder of the self is the
foundation, core, or origin of the intersubjectivity disorder.
In the second part of this chapter, I also answer the second research question: Which
self-concept is suited to define schizophrenia as a self- and intersubjectivity-disorder? The
current phenomenological approach proves not to suffice to a complete account on
schizophrenia. I argue that a vital aspect of the illness is neglected if the phenomenological
contribution is restricted to its current form. A more adequate concept, encompassing both
self and intersubjectivity disturbances, is therefore required. In this respect, open subjectivity
proves to be an entirely suitable concept. I consequently explain the concept in more detail.
This chapter thus integrates the results from Chapter 2 and Chapter 3 and it pieces together
both philosophical and psychopathological insights.

4.1 From self-disorder to intersubjectivity-disorder

From the early descriptions by Kraepelin to the most recent accounts based on the ToM
paradigm, a variety of symptoms, signs, and phenomena show the importance of
intersubjectivity in schizophrenia. Differently, the self-disorder hypothesis relies on the
accounts of classic and phenomenological authors, who did not piece together the evidence so
far collected. Nevertheless, the results stemming from the previous chapter allow me to claim
that a phenomenological account of schizophrenia should strongly integrate the
intersubjective dimension.142
The question that arises now is instead how the traditional account of schizophrenia as
self-disorder relates to the previously described intersubjectivity disturbances. Could it be that
the disturbances of intersubjectivity are all secondary to some core alteration amounting to a
diminished sense of self and hyperreflexivity? In brief, one might well want to claim that all
symptoms and signs of schizophrenia ultimately relate to a disturbance of the minimal self.

142
What is meant here by ‘intersubjective dimension’ was made clear in the second section of Chapter 3.

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This does not mean that other, higher layers of self are taken as not affected. The narrative
self, for one, can certainly be recognised as disturbed, as the patient loses a sense of
autobiographical coherence or contiguity (Sass and Parnas 2003). This approach to
schizophrenia is based on a foundational model of the self, as elaborated by Zahavi. The
minimal self is here “a necessary foundation for the articulation of a richer or sophisticated,
reflective, language-bound, narrative selfhood, with its representational elements and
dispositions” (Parnas and Sass 2011, 525). But what evidence supports this approach to the
self disorder?143 The multi-faceted significance of the intersubjectivity disturbances seems to
suggest that the foundational model should be reconsidered. This does not mean, however,
that it is my intention to simply discard the hypothesis of the self-disorder. I rather propose to
expand or complement this view in order to comfortably account for the basic alterations of
intersubjectivity as well.

The limits of the current phenomenological approach

The foundational model of the self, as applied to the self-disorder, currently prevents
the development of any perspective suitably accounting for significant intersubjective
disturbances. In order to support this claim, I will now examine to what extent
intersubjectivity is included in the self-disorder hypothesis, and I will compare this finding to
the disturbances I have previously elucidated.
Within the traditional framework of phenomenological understanding of schizophrenia,
the third component of the self-disorder, namely the ‘disturbed hold’ or ‘grip’ on the world,
comes closest to the disturbances of intersubjectivity. However, the reader already knows that
this third element tends to mostly play a side role in the psychopathological descriptions (Sass
and Parnas 2003, 436). The term is used to describe “distinctive abnormalities of the salience
and stability of the objects and field of awareness” (Sass and Parnas 2001, 348). The lack of
grip on the world is said to involve perplexity and a loss of common sense. This definition is
also echoed in the listed symptoms included by the semi-structured interview on anomalous
self-experience (EASE). This list is primarily an exploration of symptoms possibly related to
disturbances of the minimal self (Parnas et al. 2005, 236). As such, it is considered to match
the core disturbances of schizophrenia. It is worth noting that only three symptoms in this list
actually belong to the realm of intersubjectivity.
The first is a loss of common sense. It has been explained earlier how Blankenburg
(1969) and Stanghellini clarified the different meanings of common sense and to what extent

143
For an analysis of the layered account of the self, see Michela Summa’s article (2014a).

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they are relevant for the psychopathology of schizophrenia. The social form of common
sense, taken as understanding “the human game” (Stanghellini 2011, 165), matters the most
here. This includes references to the knowledge of social rules and particular ways of
conceptualizing objects, situations and other people’s behaviour. What is more, it also entails
a pre-reflective, pre-propositional attunement which allows us to establish emotional contact
with others and relate to each other’s subjective life (Stanghellini 2011, 165). In the EASE,
however, common sense is mainly used as a synonym for self-evidence. The only reference to
intersubjectivity or to the social aspect of this self-evidence is the mentioned lack of
“naturalness of the world and of other people” (Parnas et al. 2005, 249).
The second symptom which involves intersubjectivity is transitivism or confusion with
the other, described in the following terms: “The patient experiences himself and his
interlocutor as if being mixed up or interpenetrated, in the sense that he loses his sense of
whose thoughts, feelings, or expressions originate in whom” (Parnas et al. 2005, 254). This
description leaves us wondering what the normal experience of self and other ought to be.
Clearly, it seems, this ‘interpenetration’ should be absent. Yet, some of the philosophical
views introduced in Chapter 2, together with some psychopathological descriptions presented
in Chapter 3, seem to indicate that a certain kind of interpenetration is possible, maybe even
necessary.144 Transitivism shows then that the distinction between what is mine and what is
other is potentially fading. And I believe this is a key element to the understanding of
schizophrenia, as I have shown that fluid borders between self and otherness are not an
exclusive feature of transitivism, but can be also found in the delusional conviction.
The third and last intersubjective element listed by the EASE concerns solipsism. “The
patient in some way feels as if being a unique (literally or in the sense of centrality) subject in
the world, may have a fleeting sense of extraordinary abilities or powers (as if being a
creator), may experience the outer world as a figment of his own imagination (the world
becomes mind-dependent)” (Parnas et al. 2005, 255). In my interpretation of schizophrenic
delusions, it is clear that the others within the delusion are subjectified others, in that they
emerge from a solipsistic subject. They lack real alterity. Furthermore, the certainty of the
delusion stems from the subject’s immanence and is closed to ‘external’ influences.
I believe these three elements to be absolutely correct, however thus far, neither a clear
explanation of how they relate to the self-disorder, nor of the overall role of intersubjectivity
in this hypothesis has been provided. Furthermore, there are other symptoms, signs, and

144
See for example Minkowski (1966, 461), Kimura (1985, 193), and Merleau-Ponty (2005, 497). I come back
on this argument in the second part of this chapter, when discussing the meaning of ‘open subjectivity’.

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phenomena that are relevant to schizophrenia, which have not been listed in the EASE. On the
whole, it would be very difficult to try and derive all the intersubjectivity disturbances from
diminished self-affection and hyperreflexivity. It is even questionable whether this would be
an adequate approach for a phenomenology of schizophrenia.
The difficulty to integrate intersubjectivity disturbances into the self-disorder hypothesis
is arguably the direct consequence of the philosophical assumptions on the nature of the self.
The problem finally comes down to the irreducibility of intersubjectivity, in both its mundane
and transcendental form, to subjectivity. The self-disorder hypothesis focuses on one kind of
self that is not immediately connected to others, while the philosophy of intersubjectivity as
presented Chapter 2 has strongly claimed this connection.145
The reader might recall that Husserl’s successors criticize his approach to
intersubjectivity, by arguing that his starting point on intersubjectivity is an absolute self-
certain I (Waldenfels 1971, 403). Nevertheless, in his use of the abstraction in the
intersubjective reduction, Husserl implicitly assumes the ontological connection with the
other. Yet, he fails to clarify its role for the experience and constitution of the subject.
Heidegger claims that Dasein is being-with (Mitsein), and this is not just a factual or ontic
description of the impossibility to be alone in the world, but it carries an existential-
ontological meaning (Heidegger 1967, 120). Merleau-Ponty, for his part, explains our
understanding of others as based on intercorporeality (Merleau-Ponty 2005, 215). This
implies that “the own and the alien are entangled, that everybody is inserted into an
interlacing” without readymade individuals (Waldenfels 2004, 246). According to this
perspective, individualization only follows from this pre-existing anonymity of the
intercorporeal being (Merleau-Ponty 1968, 143). Furthermore, Waldenfels remarks that the
immediate intersubjective connection is also part of our everyday practical engagement in the
world. He argues indeed that the other in the encounter is not primarily the object of our
observations, but a co-subject in a common practical involvement (gemeinsamens Tun)
(Waldenfels 1971, 136).
These views on a significant connection with the other do not imply that the distinction
between self and other disappears. Levinas (1961, 21, 23, 29, 83) and Waldenfels (1971, 138;
2006), for example, both emphasise the otherness of the other through the experience of

145
Not all definitions of the self-disorder exclude the direct intersubjective relation. Fuchs (2010a), for example,
defines the core of schizophrenia as affecting embodied self-affection, as it has been outlined in the first chapter.
Because of this strong emphasis on embodiment, and because of the related idea of intercorporeality, this view
on schizophrenia can include intersubjectivity disturbances. The disturbances of intercorporeality, such as the
difficulties with affective attunement in direct contact, however, do not enable us to account for the disturbances
of transcendental intersubjectivity, which certainly do play an important role.

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surprise, appeal, and the need to respond. We are in continuous dialogue with each other, and
we only break this dialogical connection when objectifying the other, Waldenfels claims
(1971, XI, 368). The previously introduced description of the encounter in schizophrenia as
objectified intersubjectivity makes clear that the alteration of intersubjectivity affects this
primal connection to others. Hence, it seems that there is no philosophical reason why the
intersubjective aspect of schizophrenia should be downplayed.
Could it be that the relative scarcity of studies on intersubjectivity and schizophrenia
stems from a lack of clinical relevance of intersubjectivity? I believe this is not the case, as
intersubjectivity is of major clinical importance. Conversely, the problems connected to the
current self-disorder hypothesis are not just conceptual and theoretical, but may have clinical
implications too. Contrary to the ‘core’ or ‘minimal’ subjective dimension, the intersubjective
dimension of the disorder is the only one we can explicitly influence as clinicians and
caregivers. I do not claim, thereby, that there is no possibility of alleviating the subjective
suffering of the patient, nor would I argue that psychotherapy and pharmacotherapy have no
influence on the symptoms and phenomena of diminished self-affection or hyperreflexivity.
However, the symptoms, signs, and phenomena of disturbed intersubjectivity are present
within a social context. It is also in this context that they become accessible to therapy. A shift
in focus from the subjective to the intersubjective may thus increase the possible therapeutic
targets.
Schlimme and Schwartz, for example, argue in their article on recovery from
schizophrenia that the impaired intersubjective resonance of the schizophrenic person often
leads the interlocutor to intuit that the schizophrenic person lacks explicit self-awareness
(Schlimme and Schwartz 2012, 102). Because of the intersubjective difficulties, a ‘mismatch’
occurs between the patient and most other people, and the latter may experience the former as
not to be trusted, as talking incomprehensible rubbish, or may find the patient irritating
(Schulze and Angermeyer 2003). People with schizophrenia may certainly lack insight or not
consider their symptoms as part of a mental disorder, but they are not usually confused or
distracted in the sense of no longer being aware of themselves (Schlimme and Schwartz 2012,
102). Schlimme and Schwartz suggest that social support thus actually influences recovery
from schizophrenia: “Social cover can be experienced in the sense of others ‘covering for me’
(i.e. helping me in a potentially embarrassing/compromising/dissonant situation with an
excuse and support). It is this experience of social cover which can demonstrate that one is
truly supported by a person or a community and which corresponds to one’s experience of
being integrated into a supportive relationship” (Schlimme and Schwartz 2012, 104). Other

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researchers have argued that recovery involves feeling normal again, through increased
interaction and re-integration into a community (Borg and Davidson 2008; Topor et al. 2011),
and social support is claimed to be the most important factor for subjective wellbeing in
schizophrenia (Buchanan 1995; Beels 1981). From this perspective, it would be worth
focussing on the intersubjective disturbances of schizophrenia, in order to ‘cover’ for them
socially.
One workgroup gathered around Seikkula in Finland has developed a therapeutic
approach called ‘open dialogue’ which appears to be based on similar ideas. They argue that
therapy for psychosis should consists of a network of caregivers, family, and friends
(Seikkula and Olson 2003). A voluntary social process (a so called ‘open dialogue’) is used to
generate meaning for something that seems to go far beyond the explicable, namely psychotic
experiences. As one of Benedetti’s schizophrenic patients explains after an episode of
psychosis: “You only have such absurd words at your disposal, and their chaos renders you
speechless: you need someone urgently, who could give you the right words for the
experience, rather than someone who tries to deny them” (Benedetti 1991, 88).
If phenomenological psychopathology aims to be truly unique in its primary interest in
the patients’ subjective experience, that is to say in the first-person perspective, then
intersubjectivity cannot be neglected. Especially since the role one plays in the community,
the self one becomes in interaction, and the shared world one experiences with others all
contribute to the subjective wellbeing of every person, patient or not, and therefore, to
recovery. The social world is a permanent dimension of existence, as Merleau-Ponty writes:
“I may well turn away from it, but not cease to be situated relatively to it” (Merleau-Ponty
2005, 421).
A key point that I wish to make in this text is that schizophrenia is not just a disorder of
one person, of one self, or of one brain. It is a disorder of self and intersubjectivity concerning
how you and I directly and indirectly inter-relate. One could be tempted to conclude that
schizophrenia is a disorder of the ‘relational self’, yet, this description would fail to grasp the
‘minimal aspect’ that the current self-disorder hypothesis targets.

4.2 Open subjectivity

In the attempt to overcome the limits of the current phenomenological hypothesis on
schizophrenia, I should answer the second research question: Which self-concept is suited to
define schizophrenia as a self- and intersubjectivity-disorder? One possibility would be to
claim that schizophrenia is a disorder of the social self (Mead 1913) or of the relational self

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(Andersen and Chen 2002).146 Although these concepts might allow a suitable description of
(some of) the intersubjective disturbances, they fail to account for the subjective dimension. I
therefore propose not to think about schizophrenia as a disorder of a particular type of self,
but of an orientation, an attitude, or a capacity of the self, which I call open subjectivity. This
latter is neither a self, nor is it restricted to one of the layers of the self, like the minimal or the
narrative self. Before venturing into details concerning what this concept means, I can already
say that it is a dynamic interaction between the layers of subjectivity and the sphere of
intersubjectivity. It is the capacity or attitude that allows for the emergence and dispersal of
the sense of self and the sense of other.

4.2.1 What is open subjectivity?

Despite my claim that the philosophical assumptions on the self have led to a relative
neglect of intersubjectivity disturbances in schizophrenia, the phenomenological tradition
does indeed offer fruitful ideas towards the definition of open subjectivity. Zahavi, for one,
explains how intersubjectivity plays a crucial role in the transcendental constitution of reality.
However, he emphasises that it only does so within an a priori subjectivity that allows for the
development and deployment of all the spheres of intersubjectivity (Zahavi 2009, 146;
Husserl 1973c, 426). Husserl argues that it is only when an “alien body enters in between the
solipsists” that transcendence emerges within the primordial sphere (Husserl 1973b, 8). And
therefore, “we can say that this solipsistic world was still just an “immanent” world. It did not
transcend me at all” (Husserl 1973b, 8). One could thus conclude that the priority of the ego is
limited to the sphere of immanence, while the constitution of the ego requires the
transcendence of this immanence through the other and otherness. Husserl is well aware of
the problematic nature of the relation between subjectivity and intersubjectivity, as testified
by his three volumes on the topic. His monadology is, I believe, an attempt to suitably
account for this relationship. On the one hand, he argues for the primordiality of subjectivity
with its immanent sphere of experience. On the other hand, he admits that intersubjectivity
influences our experiences, and therefore, our immanence. Open intersubjectivity is a clear
example of this latter influence (Husserl 1973b, 289). However, I do not think that describing

146
Andersen and Chen describe their psychological perspective on the interaction between self and significant
others. They argue that a variety of relational selves emerges in contextual interactions with specific others.
Their claim is that an individual’s repertoire of relational selves is a source of interpersonal patterns involving
affect, motivation, self-evaluation, and self-regulation. Although I value their ideas and agree that our interaction
or our form of being-with-others determines these interpersonal patterns, I do not think this is the correct concept
to describe the intersubjectivity disturbances of schizophrenia.

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the relation as monads with windows (Husserl 1973a, 260; 1973b, 295) actually solves the
problem.
‘Open subjectivity’ does not mean that the subject dissolves into intersubjectivity.
Evidently, there would be no intersubjectivity without subjects. Secondly, my experiences are
mine. “The ‘mineness’ of my body is rooted in the manner of appearance, which distinguishes
it from other bodies” Husserl explains (Husserl 1973a, 25). The point is that schizophrenia is
not exclusively a matter of the subject’s self-experience, but of a kind of being, and thereby
experiencing, that is open to the other. ‘Open subjectivity’ is a term that simultaneously
accounts for the fact that the other is other, and that despite my attempts at understanding, and
despite the reciprocal influence on our experiences, we remain other. Husserl himself admits
that empathic understanding is open, indeterminate, or incomplete (Husserl 1973a, 225). We
have open expectations or estimations of the others and their mental life. This openness
towards others is required for the constitution of our experience of reality, for empathic
understanding, but also for the constitution of our ego (Husserl 1973b, 170). I suppose that
Husserl’s monadology, and particularly the metaphor of the windows, was an attempt to grasp
how this relation between self and other influences even our most immanent sphere of self-
experience.
From the phenomenological perspective, intersubjectivity is a matter of consciousness,
and it is displayed in both my active behaviour and in the sphere of my passivity, affection,
and plain receptivity. As Husserl claims: “We orientate ourselves in our life of sensations, we
orientate ourselves according to ‘our’ and not just to one’s own experiences” (Husserl 1973b,
197). Individually, and passively, we indeed integrate the intersubjective into our
transcendental consciousness. However, the mundane reality of being-with-others is actively
formed through intersubjectivity. Everybody could say: “I have been in connection with
others for as long as I can remember”, meaning that my understanding and interpretation of
the world is formed by the interaction with others, and it is formed that way again and again
through interaction (Husserl 1973c, 173), as it has been argued in Chapter 2.
The concept of ‘open subjectivity’ is able to usefully contribute to the description of
both the essential alterations in schizophrenia and the ‘normal’ relation between self and
others, inasmuch as it bypasses the distinction between the mundane and the transcendental.
This distinction is certainly relevant for phenomenological investigations, although the reader
should bear in mind that it is a form of abstraction, similar to the phenomenological
reductions. This means that no moment of experience is actually divided into an empirical or
real world experience, and a transcendental experience. Since open subjectivity, as it will be

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made clear further on, has a role to play on both the transcendental and the mundane level,
and given that the disturbances of schizophrenia are displayed equally on both levels, it is
clear that this distinction will be less relevant.
Essentially, I understand ‘open subjectivity’ as the attitude, capacity, or orientation of
each subject in relation to others. Such a relation should be understood as the openness of the
primordial or ‘own’ sphere. In an attempt to clarify the definition and the role of open
subjectivity, both in schizophrenic and in healthy individuals, I will investigate five different
dimensions or fields pertaining to open subjectivity. The first is the temporal dimension,
where open subjectivity is prominent in the protentional function of inner time consciousness
as well as on the higher layer of narrativity. The second is the spatial dimension, where open
subjectivity acts in the in-between of encounters. The third field is connected to the affective
dimension of human life. Fourthly, open subjectivity is taken to be an essential element for
the experience of reality and of the shared world. Lastly, open subjectivity proves to be
relevant in the realms of self- and other-awareness, i.e. the sense of self and the sense of
otherness.147
How could open subjectivity be defined then? Open subjectivity is a dynamic, selective,
and potential orientation of the subject towards others. It is dynamic, inasmuch as the
openness itself can widen, narrow, or even close. It is selective, as the openness of
subjectivity is not ever-present and our subjectivity is not influenced or penetrated by every
intersubjective factor. It is potential, since it is not the openness itself which is necessarily
present, but its potentiality, that is, the possibility of subjective openness towards
intersubjectivity. It is a form of subjectivity, of being a subject. It is not a kind of self, but a
capacity or characteristic of each level of being a self. Open subjectivity is displayed in our
encounters with others, in our experience of the world, and in our sense of self and other. 148
As Zahavi claims, open subjectivity is a condition for ‘normal’ self-experience: “Subjectivity

147
The idea of open subjectivity shows affinities to Levinas’ work on freedom as heteronomy. He explains there
that the other’s call pierces our fixed identity and opens us. It leads us towards the infinite and to our
responsibility of the other. This, Levinas claims, is true freedom in heteronomy (Levinas 1961; Zhao 2014). He
argues that the self cannot be, because the other already calls me out of myself ‘in exile’ (Zhao 2014, 552).
Although the heteronomy he describes differs from the heteronomy of open subjectivity, particularly because of
his emphasis on the ethical context, we both understand heteronomy as positive. In my view, it is only when the
influence ‘from the outside’, or from others, becomes rigidly blocked or avoided, that problem arise. The term
can also be found in Kelly Oliver’s book on subjectivity. The meaning of the term is different, as she uses it with
regard to the mother-child relation (Oliver 1998).
148
I chose the term open subjectivity over other alternatives, such as open consciousness, since I believe the
intended openess is not only transcendental or restricted to the constitution of experiences, but it is equally an
openess within the experiences one has of the world, e.g. social interaction. In Husserl’s terms, it is not only
noetic but also noematic openess.

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is open towards and engaged in the world, and it is in this openness that it reveals itself”
(Zahavi 2000).
Back to the specific topic of this inquiry, one may still wonder: How is open
subjectivity affected in schizophrenia, and is this indeed a suitable concept for a unified
account of the variety of its symptoms, signs, and phenomena? It has been mentioned earlier
that Minkowski and others used the terms syntonia and schizoidia to describe principal
tendencies in social life. Furthermore, in the second section of Chapter 3, the several
disturbances affecting the understanding of others, the affective attunement and
intercorporeality, and sociality in general, have been discussed as examples of disturbed
intersubjectivity. On the whole, it has been made clear that schizophrenia is not just a matter
of social difficulties, but of disturbances of transcendental intersubjectivity as well. In this
light, it would then be unsatisfactory to simply follow Minkowski and others and reduce
schizophrenia to a matter of balance between syntonic and schizoid tendencies, or even to
restrict it to a social disorder. Based on the previous account concerning the contributions of
the phenomenologists discussed in Chapter 2, I conclude that transcendentally, the subject’s
immanence is and should be interwoven or saturated with intersubjectivity.
Based on the idea of a disturbed open subjectivity, the several levels entailing
intersubjectivity disturbances in schizophrenia can be easily accounted for. The alterations to
the category of mundane intersubjectivity have been previously described as ‘objectified
intersubjectivity’. Under this label are notably grouped together all sorts of perturbed
encounters with others, including alterations affecting the understanding of others, the
attunement and affective resonance, as well as sociality. All these signs display subjectivity
rigidly shutting down in the encounter with others. On the level of delusions, the closing
subjectivity results in what I called ‘subjectified intersubjectivity’, which implies self-
centrality and the lack of otherness. On a transcendental level, instead, the disturbances
affecting the higher layer of normativity and conventionality are displayed in the form of a
disturbed integration of the intersubjective ‘rules of the game’. On the lower or passive level,
once the immanent sphere is impenetrable to the regulatory influence of others within open
intersubjectivity, also the modulation of the categories of intentionality, and the validation of
reality and objectivity experiences are clearly prevented, thus resulting in a loss of
intersubjective reality, or in what Minkowski called loss of “vital contact with reality”. 149

149
See the conclusion of Chapter 3 for a systematic overview of these disturbances in relation to transcendental
intersubjectivity.

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4.2.2 Five dimensions of open subjectivity
Certain dimensions of intersubjectivity are an integral part of the subject’s individual
experience of the world. I have clarified the role of intersubjectivity on both the higher or
active level and the lower or passive level of experience. Nevertheless, the openness of
subjectivity and the presence of intersubjectivity within the subjective sphere do not dissolve
the subject. In order to further clarify the role of open subjectivity, I will study five specific
dimensions where this feature of subjectivity is at work, and where it possibly relates to
schizophrenic alterations.

Temporality: implicit and explicit time

In order to understand open subjectivity in the temporal dimension, it is useful to bring
in again the distinction between implicit and explicit time.150 Implicit time is based on the
constitutive synthesis of inner time consciousness on the one hand, and on the conative–
affective dynamics of life on the other. Explicit time is the result of an interruption or
negation of implicit time and unfolds itself in the dimensions of present, past, and future.
Implicit time is based on the fluid and tacit bodily functioning and on affective
synchronization with others, while explicit time arises through states of desynchronisation, for
example through retardation or acceleration of time experience in relation to the social sphere.
First of all, implicit or lived time is “to live time” (Kupke 2006). It is the movement of
life, implicit in our experience of being engaged in the world and oriented towards our
immediate goals. It is present in our bodily commitment to our particular situation. Implicit
time is the undercurrent of our experience (Fuchs 2013d, 2). As mentioned earlier, Husserl
famously described how inner time consciousness consists of a synthesis of three moments:
protention, primal impression, and retention (Husserl 2012, 44). Protention is the open
anticipation of the experiences which are to come. Primal impression consists of the primal
impression as given at every moment. The retention consists of retaining what has just been
experienced as it slips away. Speech is a good illustration of this: we hear the current spoken
words (primal impression), but we are also aware of the words we have just heard (retention)
and we anticipate certain words to come (protention). The synthesis of these three elements
makes that our experience is fluid, dynamic, and unified. Clearly, this is a passive process and
the subject is not actively or reflectively combining protention, primal impression, and
retention. Passive or implicit syntheses are the medium through which we immediately

150
My interpretation of temporality in schizophrenia is strongly based on three articles by Fuchs and the
psychopathologists I have discussed in Chapter 3. An overview of temporality and schizophrenia according to
Fuchs and myself will be published as an ancillary article to the Examination of Anomalous World Experience
(EAWE).

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perceive the world and interact with it. The result is an integration of the sequence of single
moments into what Merleau-Ponty (2005) called the ‘intentional arc’, enabling us to direct
ourselves towards objects and goals in a meaningful way (Fuchs 2007, 229).
Explicit time is constituted by the three components of past, present, and future.
Similarly to the unifying activity of protention, primal impression, and retention through the
passive synthesis, past, present and future need to be synthesized as well. In other words, it
requires an active synthesis by the subject. The personal or narrative self then binds the three
parts together. The personal self is thus capable of projecting oneself into the future, and to
appreciate one’s own life story as a narrative entity. In fact, this is a form of explicit
‘objective’ temporality, especially as soon as the narrative is shared with others. One good
example is provided by the temporal narrative we share with our culture, with our family, or
even within a relationship. Furthermore, we create artifacts to attune our subjective time
experience to others, like calendars and time-tables. Explicit time is therefore certainly
intersubjective. It is the experience of time in relation to others, to their relation to time, and
to an overarching temporal flow.
Like explicit time, also implicit time has an intersubjective aspect. Rodemeyer (2006,
183) argues that the temporal structure of consciousness and in particular protention is a
necessary correlate of intersubjectivity, and in particular of inter-affectivity. Protention also
means openness to the other, and it is a condition for affectivity, as well as for being affected
by others. Inner time consciousness, or subjectivity, is therefore “open to intersubjective
horizons” (Rodemeyer 2006, 183).
Importantly, the openness of the protention is not unlimited, nor is it static. Fuchs uses
the figure of the ‘cone of probability’ to describe the changes to protentional openness. A
central aspect thereof is that the protentional cone can widen and close. This means that
temporal openness is dynamic and selective. Retention and impression fundamentally
motivate protention: we emptily expect something rather than something else. Finally, based
on this temporal dimension of open subjectivity one of its distinctive feature comes to the fore
as dynamic opening and closing, depending on and motivated by previous and current
experiences. This explains, transcendentally, why not every possible intersubjective factor
influences us, e.g. a cultural value that one does not share.
In schizophrenia, disturbances of temporality have been amply described, both
phenomenologically as well as empirically.151 One example of disturbance of temporality in

151
See for example (Fuchs 2006; 2007; 2013d; Kupke 2006; Vogeley and Kupke 2007; Sass and Pienkos 2013b;
Stanghellini et al. 2016).

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schizophrenia with strong links to intersubjectivity is perceptual fragmentation.152 It has been
made clear by this inquiry that if a subject perceives an object without open intersubjectivity
and thus without the possibility of apperception, the subject can only perceive what is actually
given to him. The lack of apperception then leads to perceptual fragmentation.
Unsurprisingly, the same fragmentation can also be described as a disturbance of the
protentional function of inner time consciousness. The specific openness towards what could
follow is here disturbed. As Husserl argues, temporality plays an all important role in
subjectivity. Based on this account, it allows for the ‘open’ connection to others.
Other psychopathologists have equally studied temporality in schizophrenia. As
previously mentioned, Minkowski’s concept of the loss of vital contact with reality entails a
loss of rhythm or a desynchronisation. Sharing a rhythm stands for the possibility of contact
with others (Minkowski 1995, 59). 153 Also Kimura describes a temporal alteration in
schizophrenia in terms of an ante-festum orientation: the schizophrenic patient seems to
anticipate the future, however his acts, thoughts, and speech are often incomprehensible
without knowing what the patient is exactly anticipating. Normally, the “practical and active
relationship of the subject towards the world is internally directed by a meta-noetic
prospective” (Kimura 2000, 72), that is, by an intersubjective or transpersonal temporal
orientation. This ante-festum orientation and the concrete manifestations thereof, such as fear
and anxiety, Kimura claimed, are the consequence of the patient’s awareness of losing a
stable self in an intersubjective world (Kimura 1992, 79, 144).
The temporal dimension of open subjectivity is thus characterized, firstly, by an explicit
level of temporality. On this level, intersubjective temporality is integrated and regulated into
one’s own subjective time experience. Concerning schizophrenia, Minkowski’s and Kimura’s
descriptions provide viable examples of disturbances on this level. The temporal dimension of
open subjectivity is, secondly, characterized by openness of the implicit level of temporality,
i.e. by protentional openness. Whenever the protentional function of consciousness breaks
down, as Fuchs describes it, open subjectivity, or the gateway to affectively experiencing
others closes down.

152
See Uhlhaas’ and Mishara’s (2007, 143-144) examples of a patient who reported not to be able to see the
whole garden, only a bird, and who could only concentrate on a particular perceptual detail.
153
This certainly goes for affective resonance, as developmental psychology has shown (Beebe et al. 2003; Stern
1985). The rhythmicity of the interaction, rather than complete congruence, is a necessary requirement for
smooth interpersonal contact (Fuchs 2013d, 81).

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Spatiality: in-between the spheres of self and other
Because of the embodied aspect of subjectivity, one could assume that our skin
functions as the border of our subjectivity. This border would then prevent our subjectivity to
disperse or dissolve in contact with others. However, I think transcendental intersubjectivity
proves that this is only one aspect of subjectivity. Our skin cannot function as the border for
all of our selfhood, and I would claim that the borders of our subjectivity are actually open.
Sometimes this openness of our self can be experienced as a threat, as Stanghellini’s young
patients report. They say that others and their common sense seem to menace their
authenticity (Stanghellini 2001). Such a threatening experience certainly makes more
understandable why someone would avoid contact and withdraw into isolation. However,
normally, the self we become in interaction is somewhat stable and hardly in danger of
disappearing or dissolving when in contact with others. We allow the influence of the other on
who we are, narratively, intellectually, and socially. Subjectivity can be thus conceived of as a
sphere, with its centre in our body, and with extensions beyond the borders of our skin.
Furthermore, individual spheres can arguably penetrate or overlap to form an ‘in-between’.
To be in a reciprocal loving connection with someone is a good example of such inter-
penetrating spheres of subjectivity. One shares what would often be highly intimate
experiences and foremost affects.
In schizophrenia, the symptoms of social isolation, social anxiety, and the disturbances
of affective attunement express the lack of this in-between, where overlapping subjectivities
co-constitute or at least reciprocally influence each other. The idea of a sphere is certainly not
new in psychopathology. It can be found in Kimura’s description of the experience of
threatening otherness in one’s own subjective sphere (Kimura 1992, 119). Husserl also
describes the subject as having their own original sphere (Eigenheitssphäre). He notably
distinguishes it from the intersubjective sphere (Husserl 1973b, 385). According to the
perspective adopted by this inquiry, the distinction between the two spheres is, however, less
clear than what Husserl argues. The subjective sphere is permeated by the intersubjective, and
of course, it is true also the other way around. Waldenfels explains how these spheres first
emerge: “We do not have two original spheres, which firstly have to be united, but we have
one sole sphere, which allows isolation and explicit unity” (Waldenfels 1971, 156). After this
one sphere becomes individualized, the subject is able to relativize his or her own perspective.
One schizophrenic patient often repeated that he lacked a particular in-between
(Zwischen) that connects healthy individuals to their world (Umwelt), an in-between that
simultaneously connects us, and guarantees distinction and distance (Blankenburg 1971, 86).

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This feeling of lacking an in-between is something Anne R. also described when she said that
she failed to experience an affective connection towards others and the world (Blankenburg
1971, 87).
Based on Spitzer’s definition of schizophrenic delusions (Spitzer 1989, 115), it is clear
that something about the in-between of these spheres radically changes when schizophrenia
occurs. It is not the case though that the distinction between the spheres of subjectivity just
vanishes. My understanding of this process rather identifies two main alterations of the in-
between. Firstly, the private sphere of the schizophrenic person seems to gain an
intersubjective character, particularly in the case of delusions. Something as private as a
suspicion or a premonition acquires the value of truth with all the features of intersubjective
validation. Secondly, the in-between where the two spheres of subjectivity normally overlap
becomes univocally dominated. The open interaction between the spheres rigidly closes.
‘Open subjectivity’ also offers a new perspective on the psychopathological analysis of
delusions which claims that a problematic ‘otherness’ is experienced within one’s own
subjectivity (Kimura 1992, 65-66). This otherness is only problematic once it becomes
alienated or objectified. I believe such experiences are only possible when subjectivity loses
its openness. Normally, we are aware that the others are not part of my subjectivity, but that
they are not just objects of my experience of the world either (Waldenfels 1971, 31). We
unconsciously allow the influence of others into our most intimate experience of the world.
Yet, in schizophrenia, with objectified intersubjectivity of the encounter, and with subjectified
intersubjectivity within the delusion, this open interplay between subjectivity and
intersubjectivity comes to an end.

Affectivity
The third aspect of open subjectivity is affectivity. Open subjectivity, as previously
argued, is not exclusively a matter of the transcendental or the mundane, and affectivity helps
to illustrate precisely this point. Affectivity implies indeed openness on both levels. On the
mundane level, we are passively open to being-affected by others. We feel spontaneous
sympathy when we see someone suffering, especially when we somehow identify with him or
her. Without this identification, it may very well happen that we do not feel any sympathy.
Our sympathy is restricted, it has its limits. In the same way, the other aspects of open
subjectivity are restricted and selective. Not everyone influences us, not every cultural or
communal truth becomes our truth. Not every norm determines our behaviour.
Transcendentally, instead, shared reality is experienced affectively. According to
Waldenfels: “A certain inexpressible community is formed by the sharing of the mere sensed.

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The full actuality is reached, not when we can potentially perceive the same (as in open
intersubjectivity and apperception), but when we are affected by the same. And when we are
interested in the same, and react in the same way (…) This is the only way in which we
experience the world as the same for each other” (Waldenfels 1971, 152).
The incomprehensibility of schizophrenia, but more so the disturbances of affective
attunement and empathy, arguably amount to the closing of subjectivity: for the affective
inflow of the other’s sphere into mine is obstructed. Based on the accounts provided by
developmental psychology, it has been argued that already very early in someone’s life shared
affectivity and attunement are clearly displayed. This primary intersubjectivity remains
supposedly present throughout our lives, even when we have acquired and exhibit more
sophisticated forms of intersubjectivity. This means that normally, our subjectivity allows for
a substantial being-affected in interaction. In this regard, the difficulties to make oneself
understandable to others, the descriptions of the ‘abyss’ between the schizophrenic person and
others, and the examples of derealisation of others (what I have called objectified
intersubjectivity) reveal some dramatic change in the affective side of open subjectivity.
However, it is clearly not the case that all affective experience decrease with schizophrenia.
The affectivity that co-determines open subjectivity is intersubjective affectivity, while not all
affectivity is intersubjective. Bleuler describes very early that the “joy of a schizophrenic
patient does not make us joyful, his expressions of pain leave us indifferent. In the same way
the patients do not react to our own affects” (Bleuler 1955, 337). The joy is therefore still
there, while the intersubjective sharing of it is regrettably missing.
It is remarkable that the current phenomenological approach to schizophrenia seems to
neglect or minimize affective difficulties in schizophrenia, even though empirical research
suggests that it plays a larger role than often assumed (Myin-Germeys and van Os 2007).
Anxiety and anhedonia have exceptionally received phenomenological attention (Sass 2004;
Parnas et al. 2005; Raballo and Parnas 2012). Interestingly, these are forms of affectivity
which are less likely to be considered to be intersubjective phenomena. 154 Notwithstanding,
Kraepelin (1904, 182), Bleuler (1955, 377), Minkowski (1921, 255) and Blankenburg (1971,
87) argued that an affective disconnection from the other is one of the key elements of
schizophrenia. Unfortunately, when restricting our understanding of schizophrenia to a
disturbance of the minimal self, the whole affective dimension ends up being overlooked.
Within such a framework intersubjective affectivity is credited only with some secondary

154
It can be argued that anxiety and anhedonia in schizophrenia are mostly intersubjective phenomena, as the
anxiety is often a social anxiety and anhedonia is mostly social anhedonia (Brown et al. 2008; Wang et al. 2014).

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position to the self. The neglecting of its role directly results, in my view, from the core
concept of an isolated self prior to any contact with others. However, contemporary research
has widely proven that affectivity implies indeed interpersonal experiences and it shows how
humans are relational beings. “To be impaired or incapacitated in participating in the
interaffective space that we share with others is probably the most serious suffering which
mental illness can cause to those afflicted” (Fuchs 2013b, 628).

Reality
Besides the temporal, the spatial, and the affective aspect of open subjectivity, I now
return to how it functions in our experience of reality. The second section of Chapter 3 has
already shown how schizophrenic delusions are disturbances of intersubjectivity, in both the
higher and the lower layers of experience. The disturbance of intersubjectivity that I have
described there logically leads to a disturbance of the experience of reality, and in particular,
of the co-constitution of reality. Can this disturbance be clarified by ‘open subjectivity’? The
basic conclusion ensuing from my account of the influence of intersubjectivity on reality
experience is that deviations from normality and conventionality are displayed on the higher
level of constituting a shared reality through common sense. However, also on the lower
levels of passivity, perceptual disturbances correlated to a dysfunction of ‘open
intersubjectivity’ can be reported, including perceptual fragmentation, ‘shift of meaning’, and
derealisation. Blankenburg argues that intersubjectivity determines our experiences of reality
through the categories or forms of experience and thought, rather than through their content
(Blankenburg 1971, 116). In this view, without once experiencing validation by others, I
would not be able to attribute a sense of reality to my perceptions. I would be able to say that
I see a house, but I would thereby not necessarily believe that the house I see exists (Husserl
2012, 18-19; Waldenfels 1971). Furthermore, Kimura elaborates the concept of
intersubjective Aida as the meta-noetic principle that integrates the intra-subjective Aida’s of
every individual (Kimura 2000, 52). He explains that this kind of meta-noesis is a ‘virtual’
reality in which everyone takes part and that is constitutive for each individual’s subjectivity
(Kimura 1991, 89). It is worth recalling that Husserl (1973b, 199, 205) also describes in
similar terms how transpersonal consciousness (überpersonales Bewusstsein) determines our
subjective experience.
In our practical involvement in the world, or what Waldenfels (1971, 246) calls the
“indirect dialogue”, we help each other attune correctly to the shared reality, by validating and
denying. We experience the world and the objects of the world through intersubjectivity, or as

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Merleau-Ponty describes it: “Someone uses the pipe for smoking, the spoon for eating, the
bell for summoning” (Merleau-Ponty 2005, 405).
Matthew Ratcliffe has recently used this idea to argue for a redefinition of the minimal
self.155 He argues that all we experience happens through others and through our interaction
with others. The distinction between categories or forms of experience, like the distinction
between memory and imagination, or between perception and phantasy, depends on different
forms of validation by others. 156 The modalities of intentionality are thus taken to be
dependent on others. The account provided in Chapter 3 confirms this: the traditional and
historical intersubjective patterns of experience, of anticipating the normal, and what the
normal consists of, are integrated into the purely subjective sphere of experience (Husserl
1973c, 137-138). I have argued that the apperception and the way we apperceive are inherited
from others.157 Because of the interpersonal regulation of intentionality, Ratcliffe claims, we
have to conclude that the most minimal sense of self is an interpersonal self. This means that
the sense of being a self is a form of intentionality, which is therefore interpersonally
constituted and developed. Although I am sympathetic to Ratcliffe’s attempt, I disagree with
the consequences he draws from the observation that our experience is interpersonally
regulated. Since Ratcliffe’s approach comes close to some of the elements in this text, the
difference between his view and mine deserves further elucidation.
I believe it would not be correct to claim that the minimal self is an interpersonal self
precisely in the light of an understanding of schizophrenia as a deviation from this
interpersonal process. What I found in my phenomenological and psychopathological analysis
is, firstly, that schizophrenia concerns both the pre-reflective sense of self and the
intersubjective or relational self; secondly, that it is not just a matter of empirical or mundane
intersubjectivity, but of transcendental intersubjectivity as well. Therefore, there is little use in
reducing these disturbances to the minimal self, or to the interpersonal self, for that matter. I
believe it is the orientation and capacity of subjectivity that matters, rather than the type of
self involved. This form of subjectivity is dynamic, but it requires openness, and it determines

155
The unpublished article is available online:
www.academia.edu/13585253/Selfhood_Schizophrenia_and_the_Interpersonal_Regulation_of_Experience
156
Interestingly, Sass (2014, 6) also mentions the difficulties to distinguish between categories of experience,
such as memory, perception, and imagination. However, he does not relate this to a disturbance in
intersubjectivity or to the intersubjective constitution of the categories of our experience.
157
The role of others for the development of the capacity to distinguish different modalities of intentionality
may, however, be more problematic than what Ratcliffe assumes. One could argue that it is only the recognition
of a certain intentional modality, like imagination, as this particular modality which is intersubjectively
regulated. The intentional modality itself, and its qualitative and experiential characteristics is not necessarily
regulated or formed by intersubjectivity. Thanks to Thomas Fuchs for this remark.

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how we find others and ourselves in the world, and how we experience this world in the first
place. ‘Open subjectivity’ concerns both the pre-reflective and the reflective, the mundane
and the transcendental.158 The openness of subjectivity allows for the deeply rooted certainty
in the presence of others and in the presence of the world, as described by Merleau-Ponty
(2005, 419) and Heidegger (1967, 149-150). It also supports the fundamental certainty or trust
that Husserl called ‘Bodengewissheit’ and to which Ludwig Wittgenstein (1953, §217) would
later refer as the bedrock of our language games. Delusions are then the expression of closed
subjectivity. Patients become the centre of their own experiences without the possibility to
decentralize themselves; their immanence excludes influences from beyond the sphere of their
own subjectivity. Where interpersonal contact could normally regulate the subject’s
constitution of reality, schizophrenic delusions show that the boundaries of the sphere of
subjectivity have become insurmountable.159

The sense of self and the sense of other

Some aspects of open subjectivity still need to be clarified: how is open subjectivity
related to the sense of self and the sense of other? In one of the most famous passages of the
history of philosophy, the master-slave dialectic in the Phenomenology of Spirit, Hegel
describes how self-consciousness dialectically emerges from the encounter between two
people. Hegel argued that the self becomes self-aware through the presence of the other and
his recognition (Hegel 1977, §178; Grosz 2014). He even describes the self as follows: “The I
which is we and the we which is I” (Hegel 1977, §177). Hegel was not the only one to define
this relation as dialectical. Paul Ricoeur too argued that selfhood presupposes a dialectical
relationship with otherness. Similarly to what is has been advocated at the end of Chapter 2,
he claims that selfhood implies otherness to such an intimate degree, that the self cannot be
thought of without the other (Ricoeur 1995). Again, this dialectics should not lead to the
conclusion that the self dissolves in otherness. Levinas warns about this, based on the crucial
assumption that freedom is found exactly where this otherness and heteronomy remain

158
Open subjectivity also concerns the relation between the transcendental (my immanence) and the mundane
(the present others). Earlier, I have argued that there is a certain circularity between mundane and transcendental
intersubjectivity: the encounters in the world influence our subjective or transcendental experience of the world
with others, and this transcendental intersubjectivity in turn influences how we interact and encounter others.
The suggestion that the possible foundation of transcendental (inter)subjectivity should be found in the mundane
interpersonal situation was discussed in Chapter 2 in reference to Schütz (1966, 82). On the one hand, I
acknowledge the obvious arguments in favour of this idea. On the other hand, it goes beyond the scope of a
transcendental approach to argue for a foundation in the empirical. When defining open subjectivity, it is,
however, important to emphasise that it concerns both the empirical or mundane and the transcendental.
159
The absolute certainty of schizophrenic delusions should be distinguished from ‘Bodengewissheit’, the
bedrock certainty, and basic trust. The main difference is that the former arises from the exclusion of others from
the subject’s immanent sphere: it is isolated, incomprehensible, and does not allow doubt. The latter is a shared
trust which arises with others and through the encounter with others, and as such, it is a condition for doubt.

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present (Levinas 1961). This would mean that the sense of self depends on alterity. Likewise,
Mead’s ‘social self’ emerges through dialectical movement, namely in interaction (Mead
1913).160 The reader may recall that Kimura and Nishida have been quoted earlier on the
emergence of self in interaction. Analogously to Hegel, Nishida claims that the I becomes an I
through recognition by a Thou, just like the Thou becomes a Thou only through an I (Kimura
1995; Grosz 2014). This idea appropriately emphasises how the sense of self and other are
dialectically related.
In schizophrenia, social deviations may be said to reveal a disturbance of the dialectical
process between self and other. The symptoms, signs, and phenomena of schizophrenia can be
described as deviations of the dialectical movement between being-open-to-others and being-
closed-to-others. Phenomena like syntonia, inter-affectivity, inter-regulation of experience,
inclusion, and sympathy belong to the former, while schizoidia, distinction, withdrawal, and
quasi-solipsism belong to the latter.161 The sense of self we experience both reflectively and
pre-reflectively keeps emerging from being-with-others, from the in-between, from the
overlap of the spheres of subjectivity. Kimura calls this the common place where we
constitute our selves (Kimura 1992, 37). Blankenburg’s patient describes interaction through
a metaphor that reminds of Kimura’s ‘mutual combat’. Thus a process is described which
accounts for otherness and simultaneously sensing selfhood. The self one achieves is a self in
relation to others, and the self remains ‘in-between-like’ (Kimura 2000, 115). The use of the
term ‘open subjectivity’ does not solve, clearly, all the questions on the relation between self
and other. Nevertheless, it fruitfully lends itself to the description of the alterations of
schizophrenia, alterations that concern both subjectivity as well as intersubjectivity. Based on
its features, it can be argued that we become aware of our self in interaction with what we are
not. Developmentally, the increased interaction with the mother, and later with the world, as
an expansion of openness towards ‘not-me’ or otherness, goes hand in hand with the
development of ‘me’ or subjectivity. Subjectivity develops then through the encounter with
others, while being part of an intersubjective world, and while allowing the other to
‘penetrate’ into one’s own subjective sphere. Open subjectivity is a capacity that develops in
interaction, and it fits the theories of Stern (1985) and Trevarthen (1994), who explained that

160
The question remains whether the necessary alterity is social alterity (the other) or otherness encountered in
any kind of affection.
161
Schizophrenia is not the only pathology related to a deviation from this dialectical process. One can think of
the Dependent personality disorder or of hypernomia of the typus melancholicus, as described by Kraus (1991).

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the sense of a core-self goes hand in hand with an increasing openness to intersubjectivity. 162
The causes triggering the closure of open subjectivity, as recorded in schizophrenia, remain
still unclear. However, what is known is that the openness of subjectivity to intersubjectivity
is certainly vital for the development of the sense of self and others, and therefore for all
experiences that depend on this distinction. Yet, I do not claim that because of this, every
form of subjectivity, every self, is always relational, interpersonal, or intersubjective.

4.2.3 Alterity, transitivism, and diminished self-affection

Lastly, I wish to address three issues. The first concerns alterity. Earlier in this text, I
wrote that alterity and the distinction between me and other does not dissolve through open
subjectivity. An inaccessible mystery remains in the other, despite our mutual openness. One
particular uncertainty characterizes open subjectivity: we are open and therefore vulnerable,
just like the other is vulnerable. We allow the other to influence our immanent experience of
the world and of our self, both affectively and transcendentally, while we are uncertain of the
exact impact this influence may have. The most explicit examples of this openness and
vulnerability are certain personal conversations, and especially psychotherapy. Only when
there is no such openness of subjectivity, as described concerning schizophrenia, does the
mystery or the otherness of the other dissolve. Then, I am no longer able to affectively
resonate with the other, to attune in a reciprocal dynamic. It is then, that Minkowski noticed:
“I know everything about him” (Minkowski 1995, 165). The patient has nothing to hide, it is
all out in the open and there is nothing inaccessible, uncertain, or mysterious about him.
The second issue concerns the phenomenon of transitivism. This experience has already
played a significant role in the overall direction of this inquiry towards the intersubjective
dimension of schizophrenia. Yet, does the phenomenon of transitivism possibly refute my
position on open subjectivity? One could argue that transitivism is exactly a pathological
openness of subjectivity, as the person describes a threatening openness of the borders of his
subjectivity. Schizophrenic patients with these experiences therefore do not lack an open
orientation of subjectivity, but seem to experience boundless openness. My answer is twofold.
Firstly, open subjectivity does not mean that the subject is permanently open to everything, as
I have explained earlier. The openness itself is dynamic, selective, and potential. Secondly, I
believe the experience of transitivism can only emerge as a consequence of a disturbed sense
of self and sense of other. As I have explained in the previous subsection on the dialectic

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This does not mean that maturation is a process of ever increasing open subjectivity, however. Habitualisation
in these interactions occurs, which, I would argue, motivates a particular selectivity of the openness.

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between these two, there is no sense of self without a sense of other. It is the openness to the
interaction, to the in-between, to the intersubjective sphere that permits a sense of otherness,
hence a sense of self, to appear. Transitivism, just like the absolute certainty of schizophrenic
delusions, clearly arises from the lack of dialectic interaction where the sense of self and the
sense of other originate.163
This is a key element in my understanding of open subjectivity: our sense of self and
sense of other derive from interaction and encounters. Yet, in order to experience interaction
and encounters, openness is required. Therefore, open subjectivity allows the sense of self and
the sense of other to emerge from interaction. Strong arguments in favour of this view can be
found in Guenther’s (2013) and Gallagher’s (2014) works on solitary confinement. Prisoners
forced into long periods of isolation often report alterations of reality experience, disturbances
in the sense of their own bodies, and even disruptions of the fundamental capacity to feel pain
and to distinguish their own pain from those of others: “They are no longer sure if they are
being harmed or are harming themselves” (Gallagher 2014, 4). Those who are artificially
detached from others do not only lose the shared sense of reality, but equally lose the clear
distinction between self and other. They experience what Gallagher described as ‘self-
dissolution’. He explains that this solitary confinement is a disruption of intercorporeality, and
therefore, it disturbs the minimal and embodied self (Gallagher 2014, 5). It is remarkable that
some of the key symptoms we find in schizophrenia also appear after solitary confinement:
changed reality experience, temporality disturbances, loss of the sense of bodily integrity,
transitivism, disturbances of recognizing and identifying with one’s life narrative, and
disturbances of the sense of self and other (Gallagher 2014, 6). In other words: “The loss of a
basic intersubjective dimension of existence can lead to the loss of the sense of realness, as
well as disturbances in what some have called the minimal self” (Gallagher 2014, 2).
The last point I wish to address is how a disturbance of open subjectivity relates to the
three components of the current self-disorder hypothesis, namely diminished self-affection,
hyperreflexivity, and a loss of grip. The third component is the easiest to account for: I have
already explained how the rigid closing of subjectivity for the different forms of
transcendental intersubjectivity leads to disturbances of reality experience, to delusions, and
to the absolute certainty that characterizes delusions. The loss of grip on the world and on
reality is therefore clearly related to the closing of subjectivity. The first two components may
seem harder to account for. However, according to the current self-disorder hypothesis,

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One could say that the sense of self and the sense of other are continiously created and recreated. They are
enacted through interaction.

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hyperreflexivity follows from a prior disturbance of the sense of self. Therefore, if I can
account for the diminished sense of self as an alteration of open subjectivity, I equally account
for the second component, as this is the consequence of the first. It should be clear by now
that a diminished sense of self, a disturbance of self-affection or self-awareness, can emerge
through the absence of intersubjective interactions. Gallagher’s analysis of solitary
confinement demonstrates this as well. Concretely, I would propose that if the openness of
subjectivity loses its potentiality, if there is no longer openness towards others, towards
intersubjectivity and interaction, then the intersubjective in-between fostering our sense of
self and sense of others can not develop. Therefore, a prior openness is required in order to
develop a sense of self and a sense of other. This is not restricted to the developmental stages
of infancy, where Meltzoff, Trevarthen, and Stern have demonstrated the importance of this
interaction for subjectivity. I believe it is equally present in later stages of life, and our sense
of self develops in continuous, yet selective, interaction with others. In solitary confinement,
this interaction is forcefully disrupted, and disturbances of subjectivity arise. In schizophrenia,
a disturbance of open subjectivity impedes this very interaction, equally leading to the
disturbances of subjectivity. 164 Therefore, diminished self-affection, hyperreflexivity, and a
loss of grip on reality can be accounted for within the framework supported by concept of
open subjectivity. This means that open subjectivity helps us to understand both the
intersubjective disturbances that I have elucidated in Chapter 3, and the subjective
disturbances, which the current self-disorder hypothesis has long demonstrated.

Conclusions
This chapter combined insights from the philosophy and psychopathology of
intersubjectivity. I affirmed the first research question: Is schizophrenia a disorder of
intersubjectivity? I then investigated how the self-disorder hypothesis relates to the
intersubjectivity disturbances, and mentioned the foundational understanding of this relation.
However, the intersubjective elements of the self-disorder hypothesis do not suffice to
account for the manifold of intersubjectivity disturbances. The self-disorder hypothesis is
clearly incapable of fully integrating intersubjectivity disturbances. This is problematic, not
only on a conceptual or theoretical level, but also and most significantly on a clinical level. It
is indeed clear that the integration of the intersubjectivity disturbances could increase clinical
validity and possible therapeutic targets. There is, furthermore, no reason why the relation

164
The analogy between solitary confinement and schizophrenia should not mislead the reader to believe that I
argue in favour of a social etiology of schizophrenia. The reference only proves that the primary disturbance of
open subjectivity, caused by an unknown complexity of factors, necessarily leads to disturbances of subjectivity.

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between the self-disorder and the intersubjectivity-disorder should be taken as foundational.
Further inquiry showed that this view depends on a set of philosophical assumptions on the
nature of the self. With reference to Chapter 2, I claimed that subjectivity and intersubjectivity
profoundly inter-relate and that there is no philosophical reason to exclude intersubjectivity
from the study of schizophrenia.
After clarifying the inadequacy of the current self-disorder hypothesis, I answered the
second research question: Which self-concept is suited to define schizophrenia as a self- and
intersubjectivity-disorder? What is needed is not a different self or a different layer of the self
which would correspond to the core of schizophrenia, but an entirely different concept. This
concept is that of open subjectivity. This concept stands for a dynamic, selective, and potential
openness of all layers of subjectivity, on both the mundane and the transcendental level, both
reflectively and pre-reflectively. This openness allows us to integrate intersubjective elements
into our own individual subjectivity, without dissolving the self. To clarify the role of open
subjectivity, I discussed five dimensions of its functioning as well as those schizophrenic
alterations that can be explained as a rigid closing of subjectivity related to these dimensions.
These are the temporal, the spatial, and the affective dimensions, the dimension of reality, and
the dimension concerning the emergence and dispersal of the sense of self and sense of others.
To conclude this chapter, I investigated how a disturbance of open subjectivity can lead to the
three components of the self-disorder, namely diminished self-affection, hyperreflexivity, and
a loss of grip. Open subjectivity, as a dynamic, selective, and potential capacity of
subjectivity, thus successfully passes the test as suitable concept for the integration of both
subjective and intersubjective disturbances in schizophrenia.

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 CHAPTER 5. CONCLUSION
The aim of this dissertation was to analyse, complement, and enrich the phenomenology
of schizophrenia. The scrutiny and combination of the phenomenological accounts on
intersubjectivity and of the psychopathological theories on schizophrenia has allowed me to
evaluate to what extent intersubjective disturbances are relevant to schizophrenia. This
research has finally clarified the overall and profound role of intersubjectivity in the disorder,
a role often neglected by the current phenomenological approach. It has decisively become
clear that schizophrenia is a disorder of both subjectivity and intersubjectivity. In order to
adequately integrate these two essential components, I have introduced the concept of open
subjectivity, understood as a selective, dynamic, and potential openness of all the layers of
subjectivity. Both the subjective and the intersubjective disturbances can be derived from and
explained in the light of this concept, which has also the potential to be an adequate
‘pathological organiser’.
In this concluding chapter, I intend to firstly summarize the main issues, questions, and
results of each chapter of my dissertation, then to suggest some directions for further clinical
and theoretical research based on this work.

5.1 Summary of the chapters

Chapter 1: The disorder of the self and its problems
The first chapter has introduced the topic of self and self-disorder, while also clarifying
some key issues concerning the current phenomenological approach to schizophrenia. In order
to understand what this approach consists of, I have elucidated the philosophical concept of
the self as well as the psychopathological approach to how the self can be disordered. I have
started my inquiry by comparing the ideas of Hume, Kant, and Husserl on the self. Zahavi’s
recent reinterpretation of Husserl’s work on subjectivity has then been introduced in regard to
the distinction between the minimal and the extended self. The minimal self, according to
Zahavi, has three interwoven characteristics that distinguish it from other forms of self. The
first is that it is pre-reflective self-awareness. The second refers to the first-person
perspective. And the third relates to temporality. Other authors, such as Fuchs, understand the
minimal self slightly differently, and include embodied and ecological aspects. To the aim of
clarifying the concept of extended self, the ‘narrative self’ has been described in more detail.
The distinction of different layers and types of self has been then used to evaluate self-
disturbances in psychopathology. I have therefore assessed how certain clinical disorders,

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such as major depressive disorder, anxiety disorders, and personality disorders, relate to self-
disturbances. It has become clear that only in schizophrenia the minimal self is claimed to be
affected.
Three significant approaches on schizophrenia have been charged with the explanation
of what the disorder exactly is and how it can be differently understood. Besides the
mainstream classificatory scheme of the DSM and the neuroscientific approach based on the
dopamine-hypothesis, I have discussed the phenomenological account on schizophrenia as a
self-disorder and its three essential components: diminished self-affection, hyperreflexivity,
and loss of grip. This very account has been targeted as requiring further discussion and
complementation.
After the topics of self and schizophrenia, I have introduced intersubjectivity from a
developmental-psychological perspective. Meltzoff’s work on early infant imitation has
shown that infancy is not a period of ‘adualistic confusion’. Stern has argued in this respect
that intersubjectivity is characterised by joint attention, joint intention, and interaffectivity.
These qualities only appear towards the end of the first year of life, he claims. Trevarthen, on
the contrary, describes intersubjectivity as displayed much earlier on, and as including
embodied attunement to others. Rather than on the individual differences between these
researchers, I have focussed on their shared conclusions concerning self-awareness as
developing dialogically in interaction with others, and concerning the experiences of being-
embodied-with-others as necessary condition for this.
By way of status quaestionis, I have recapitulated the current research on
intersubjectivity and schizophrenia. It has become clear that research in this field is relatively
scarce. I have explained how Stanghellini, with his focus on common sense, and Fuchs, with
his work on intersubjective temporality and on intercorporeality, do indicate that some aspects
of intersubjectivity are disturbed in schizophrenia. Differently, based on the Theory of Mind-
paradigm, schizophrenia can be said to include dysfunctions of ‘mentalizing’ and perspective
taking. After describing the purpose and method of my dissertation, I have concluded the
chapter with a full description of the two research questions of this dissertation: Is
schizophrenia an intersubjectivity-disorder? and Which self-concept is suited to define
schizophrenia as a self- and intersubjectivity-disorder?

Chapter 2: Phenomenology of intersubjectivity

In order to assess the intersubjective aspect of schizophrenia, I have firstly elucidated
what intersubjectivity encompasses. I have relied on the phenomenological ideas of Husserl,

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Heidegger, Merleau-Ponty, Waldenfels, and others to clarify their views on intersubjectivity. I
have also distinguished between two main kinds of intersubjectivity. First, I discussed
‘Encounters – The other, and others as constituted’. This is the dimension of intersubjectivity
involving direct encounters with others. In this first part of the philosophical account of
intersubjectivity, I have discussed the following topics: empathy; the distinction between self
and other; the risk of solipsism; and the role of sociality for personhood. In the second part I
have discussed ‘The shared world – I, the other, and the others as co-constituting’. There, I
have dealt with a distinctive kind of transcendental intersubjectivity, namely with the question
of how subjects co-constitute their experiences of the world. This section focus is no longer
on the dyadic relationship of self and others, but rather on the triadic relationship of self and
other towards the world. In this section I have discussed the following topics: intersubjective
reality in phenomenology; intersubjective perception; the objectivity of the world; normality;
subjectivity in an intersubjective world; and the problems of transcendental intersubjectivity.
As a result, the role of intersubjectivity has been elucidated on both levels: the mundane
and the transcendental; and in both situations: the direct encounter with the constituted other
and the shared involvement in the world with the co-constituting others. By applying
Husserl’s original ideas in addition to those of other phenomenologists, I could balance these
two forms of intersubjectivity, without prioritizing and overvaluing one or the other.
The core idea is that the subject experiences the world through open intersubjectivity,
common categories, shared affectivity, as well as through attuned expectations and normality.
These elements determine the subject’s mundane intersubjectivity, namely how one
encounters, understands, and interacts with others. In these interactions, cultural, normative,
and conventional aspects of intersubjectivity are deployed. Yet, mundane intersubjectivity is
not only the result, but also the origin of this transcendental function of intersubjectivity,
namely through the process of acquiring the categories of our experience, regulated by
‘indirect dialogue’. The experience of reality and objectivity, and the related perceptual faith
are then envisaged as depending on this mundane encounter with the other. Consequently, a
certain circularity or reciprocity of intersubjectivity has emerged, which I have addressed in
Chapter 4. Chapter 2 thus provided the tools for a phenomenological description of
intersubjectivity and its possible disturbances.

Chapter 3: Psychopathology of intersubjectivity in schizophrenia

The third chapter turns to psychopathology. The first section provides a conceptual
analysis of schizophrenia, based on the work of seven major psychopathologists. The purpose

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of this part was to investigate whether disturbances of intersubjectivity are taken into account
by the several theories on schizophrenia, and if so, what kind of disturbances. From the first
descriptions by Kraepelin to the most recent account based on the ToM paradigm, a variety of
symptoms, signs, and phenomena show the importance of intersubjectivity in schizophrenia.
Contextually, it has been made clear how and to what extent the quoted psychopathologists
have been influential for our current understanding of schizophrenia, or for the development
of the self-disorder hypothesis in particular. Nevertheless, some crucial intersubjective
elements in their work have been clearly neglected.
In the second section of this chapter, I have illustrated and analysed the nature of
intersubjectivity disturbances. In order to bring clarity to the variety of symptoms, signs, and
phenomena, I have reiterated here the distinction introduced in Chapter 2. In the first
subsection, I have discussed the kind of intersubjectivity found in encounters and immediate
contact with others-as-constituted. The disturbances related to the encounter involve
understanding others, attunement and intercorporeality, as well as sociality. I have equally
inspected the particular kind of intersubjectivity at stake within delusions. The fundamental
alteration of intersubjectivity here proves to be twofold: within the realm of delusion
intersubjectivity is subjectified, while the real others the patient encounters become
objectified. These two alterations of intersubjectivity can be said to belong to the same core
disturbance as two sides of the same coin.
In the second subsection, I have turned to the co-constitution of reality, and how
delusions are disturbances thereof. This part deals mostly with transcendental
intersubjectivity, as discussed in Chapter 2. Through the analysis of two complex delusional
phenomena, I could elucidate the factors involved in the experience of reality and its
deviations. Intersubjectivity has proven to be an important factor directly related to deviations
of reality experience. These include the deviation from normality and conventionality on the
higher levels of constituting a shared reality through ‘common sense’. Also on the lower
levels of passivity, perceptual disturbances correlated to a dysfunction of ‘open
intersubjectivity’ have been identified, including perceptual fragmentation, ‘shift of meaning’,
and derealisation. The absolute certainty of the delusion expresses the disturbed border
between self and other and turns out to be a solipsistic certainty. Even the content of
schizophrenic delusions often manifests alterations of intersubjectivity.
The third chapter thus offered clinical and conceptual elements relevant to the
description of the intersubjective dimension of schizophrenia. It can be claimed, accordingly,
that schizophrenia indeed involves a particular alteration of intersubjectivity. It affects both

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mundane and transcendental intersubjectivity, and the patient manifests these changes both in
relation to others, as well as towards the shared world.

Chapter 4: Philosophy and psychopathology of intersubjectivity

The fourth chapter combines the insights provided by both the philosophy and the
psychopathology of intersubjectivity. Here, I have affirmed the first research question: Is
schizophrenia a disorder of intersubjectivity? Then, the question has arisen how the self-
disorder hypothesis relates to intersubjectivity disturbances. This is usually considered to be a
foundational relation, with the self-disorder as the core of more peripheral intersubjectivity
disturbances. However, the elements in the self-disorder hypothesis commonly linked to
intersubjectivity do not suffice to account for the manifold of intersubjectivity disturbances. I
have then concluded that the self-disorder hypothesis is constitutively incapable of integrating
all intersubjectivity disturbances. This is problematic, not only conceptually or theoretically,
but also clinically. If phenomenological psychopathology is truly unique in its primary
interest in the subjective experience of the patients, in the first-person perspective, then
intersubjectivity cannot be neglected. The integration of intersubjectivity disturbances in the
clinical framework could increase both clinical validity and possible therapeutic targets.
Finally, there is no reason why the relation between the self-disorder and the intersubjectivity
disturbances should be taken as foundational. This latter idea actually originates from
philosophical assumptions on the nature of the (minimal) self. In Chapter 2, however, it has
become clear that subjectivity and intersubjectivity profoundly inter-relate and that there is no
philosophical reason to exclude intersubjectivity from the study of schizophrenia. I have thus
redefined, although discretely, the phenomenological psychopathology of schizophrenia by
advocating a shift from subjectivity to intersubjectivity.
The inadequacy of the current self-disorder hypothesis has led me to search for an
answer to the second research question: Which self-concept is suited to define schizophrenia
as a self- and intersubjectivity-disorder? I have argued that the problem could not be solved
by pointing to a different type of self, or to a different layer of the self. The phenomenological
account on schizophrenia requires a completely different concept to integrate intersubjective
and subjective disturbances. This concept is open subjectivity. This latter is defined as a
dynamic, selective, and potential openness of all the layers of subjectivity, on both the
mundane and the transcendental level, both reflectively and pre-reflectively. This openness
allows us to integrate intersubjective elements into our own individual subjectivity, without
dissolving the self. I have shown that open subjectivity functions in five dimensions, and

206
illustrated the rigid closing of subjectivity in these dimensions. By way of conclusion, I have
clarified how a disturbance of open subjectivity explains the three components of the self-
disorder, namely diminished self-affection, hyperreflexivity, and a loss of grip. It has thus
become clear that open subjectivity, as a dynamic, selective, and potential capacity of
subjectivity, is a suitable concept for the integration of both subjectivity and intersubjectivity
disturbances in schizophrenia.

5.2 Future research

Two main directions are to be recommended for future research. The first develops in the
clinical realm, and it applies the ideas on intersubjectivity to psychiatric research. The second
direction is instead philosophical, and it further explores the meaning and relevance of open
subjectivity.
Psychiatric research could use this work to narrowly focus on the disturbances of
intersubjectivity in schizophrenia. In order for the idea of an intersubjectivity-disorder to have
clinical impact, it will need to be explored in more detail. There are different ways of doing
so. One possibility would consist of using the descriptions and categorisation in this text as
the basis for qualitative investigations into the experience of schizophrenic patients.
Concretely, one could study the alterations in the encounter with others by distinguishing
between the three groups I have outlined, namely understanding others, attunement and
intercorporeality, and sociality. It would be interesting to evaluate how schizophrenic patients
experience contact with others and how they experience incomprehensibility, what kind of
difficulties in encounters they experience and which factors they believe to contribute to this.
Certainly, such difficulties must not necessarily be restricted to inabilities of the patient, but
they can relate to a lack of mutuality from both sides of the encounter. Furthermore, one could
explore how patients experience others to experience them. This latter approach hints to the
ToM-account, and to higher order perspective taking. When shifting the focus to attunement
and intercorporeality, topics such as empathy, sympathy, and affective resonance could be
explored from the patient’s perspective.
The idea behind qualitative research of the like is to find patterns or key issues common
to different patients, and which could be useful as items to complement this investigation, or
rather, to expand the empirical research based on subject-led formulations. The third category
of symptoms, signs, and phenomena has been linked to sociality, and this research has
emphasized the struggle in the direct contact with others, often leading to withdrawal and
autistic isolation. Here, it would be worth exploring the value of social contact and group

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interaction for the patient, notably which elements are disturbing, and which are helpful or
meaningful to the patient. Based on current research on recovery, one could speculate that
having a social role could be a supportive factor. This can be extended towards more intense
social relations like friendship, love, and family ties. The findings on social behaviour will
require to be complemented by first person accounts in order to fully account for the
alteration of sociality. A more detailed study could investigate the factors involved in the
often recorded social isolation. Enhanced knowledge on the mechanism behind this
phenomenon could increase the chances of preventing potential deterioration. Besides
focussing the qualitative research on the experience of the patient, it may also be useful to
include the perspective of others, including those closest to the patient, to evaluate
behavioural patterns of interaction within a context. This could, for example, shed light on the
open or closed nature of social contact.
Lastly, while exploring the intersubjective disturbances, one could also focus on the
disturbances of transcendental intersubjectivity: the disturbances related to open
intersubjectivity, for example, such as perceptual fragmentation, shift of meaning, and
idiosyncratic affordances, but also the disturbances of categorisation, or of intersubjective
regulation of reality experience. All these items are open for further clinical exploration.
Qualitative research could assess to what degree the intersubjectivity disturbances have an
impact on the life and wellbeing of the patient and his or her environment. Thinking one step
ahead, these explorations could then be used to establish empirical ground for further
inquiring into the prevalence of these disturbances rather than into their exact nature or
underlying disturbances. This could help distinguish schizophrenic disturbances from other
disturbances, and possibly increase the clinical validity of the diagnostic category.
Undoubtedly, the investigation concerning intersubjectivity should also be applied to control
groups of both healthy persons and patients suffering from other illnesses, e.g. personality
disorders, which may have intersubjective elements. In order to establish exactly how
profound the impact of intersubjectivity disturbances in schizophrenia is, one would need to
rely on a full account of what normal intersubjectivity is. Therefore, philosophy can qualify as
suitable source of reflection. The concept of open subjectivity may, notably, play a
meaningful role in this inquiry.
Open subjectivity is, as a concept, not only relevant to schizophrenia. It equally helps us
understand the normal direct and indirect relations between subjects. It clarifies how we, as
subjects, open up to otherness, to others, and how we close to it as well. This brings me to the

208
second main direction future research could take, namely the philosophical exploration of
open subjectivity.
First of all, I have described open subjectivity as a potential openness of all the layers of
subjectivity and I have claimed that there are at least five dimensions where open subjectivity
functions and may become disturbed. These features require more thorough investigation and
description in order to grasp the exact function open subjectivity has in integrating otherness
and subjectivity. Could it be that the extent to which a layer of subjectivity is open, or
required to be open, depends on that exact layer? Minimal self-awareness, or in short, the
minimal self, for example, may need less openness towards others than, let’s say, the social
self, or the narrative self. This does not mean that subjectivity as such is either completely
isolated or completely dispersed into otherness. Another related question is whether open
subjectivity should be ascribed to one subject, or whether it emerges and resides in between
subjects. Although I tend to think of it in the latter way, this would have to be elaborated
further.
Another important philosophical question is how, despite the openness of subjectivity, we
still experience ourselves as selves, as individual, distinct from others. An exploration of the
boundaries of subjectivity would then be useful. I believe psychopathology, and, perhaps, this
work as well, can fruitfully contribute to such a study, showing the disturbed ways in which
boundaries can become rigidly closed.
The last item I wish to suggest here concerns how one should understand the dynamic
opening and closing of subjectivity. What motivates the opening up or closing down of a layer
of subjectivity? Based on the phenomenological ideas on inner time consciousness, and in
particular the motivation behind protention, I would suggest that past and current experiences
determine the opening and closing. Affectivity, for one, certainly plays a role in this dynamic.
This last question brings us back to psychopathology, and thereby makes the circle round.
Could we argue that the openness of subjectivity can become disturbed, for example too open
or, on the contrary, rigidly closed, based on significant prior experiences? Could earlier
experiences, patterns of relationships, or triggered vulnerabilities disturb the openness, in that
it opens too much, in that it closes too often? Although I am well aware of the speculative
nature of this suggestion, it is worth noting now that also other psychopathological
phenomena may be related to disturbances of open subjectivity. Therefore, it is highly
advisable that philosophy and psychopathology jointly focus on this concept and further
elaborate its relevance.

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