Insanity―in clinical practice as in the popular imagination―is seen as a state of believing things that are not true and perceiving things that do not exist. Most schizophrenics, however, do not act as if they mistake their delusions for reality. In a work of uncommon insight and empathy, Louis A. Sass shatters conventional thinking about insanity by juxtaposing the narratives of delusional schizophrenics with the philosophical writings of Ludwig Wittgenstein.
Opmerkelijke lezing van Schrebers casus door de lens van Wittgenstein, het is een interessante kritiek op Karl Jaspers theorie van de onbegrijpbaarheid van psychotische ervaringen. Volgens mij is Sass voor een groot deel verantwoordelijk voor het alomtegenwoordige gebruik van Wittgenstein in de anglo-amerikaanse filosofie van de psychiatrie.
Sass seriously underplays the strangeness of this book, whose strategy is to make creative use of nonsense, in particular the substantial reading of nonsense in Wittgenstein's philosophy (nonsense as the expression of ineffable sense), and to thereby draw out and explain central features of Schreber's and Sass's patients's experiences of schizophrenia—especially their reports of uncanny particularity and hyperreeflexivity.
The Sassian interpretation of these experiences is that they are born of a philosophical, "quasi-solipsistic" temptation that leads inevitably toward a specific kind of nonsense, one which is signaled by the claim that "the world is my world" and which draws the person in question out from their practical engagement with the world and into a kind of dualistic delusion.
Sass seems to imply that such claims represent something ineffable behind their nonsense, something that can only be reached through that very type of nonsense, which the nonsense nonetheless cannot represent—a certain sort of glance of oneself in the mirror as both a mere object in the world and, at the same time, as the subject that constitutes this world.
Sass overlooks Wittgenstein's warning that "[t]he great difficulty here is not to represent the matter as if there were something one couldn’t do" (PI§374). And thus it ends up looking like there is a kind of schizophrenic experience (this "quasi-solipsism") that we can only grasp through the proper appreciation of the nonsensical claims made by people with schizophrenia.
One wonders why we should ever have gotten the suspicion, if schizophrenic claims really are nonsensical, that anything at all lies behind them; whether their construal as nonsense is perhaps therefore premature; or whether, if they really are nonsensical, it is not better to investigate the reasons and purposes for making use of such nonsense, rather than trying to uncover a secret sense that lurks inside it.
Schizophrenia is one of the most terrifying diagnoses a family can learn about, and notoriously hard to characterize in terms of its inner experience. In this book, the author goes back to the seminal case of Daniel Schreber (d. 1911), a very articulate schizophrenic whose memoirs served as a foundation for Eugen Beuler's characterization of schizophrenia (dementia praecox) as well as for Freud's psychoanalytic theories.
The author invokes the writings of 20th century philosopher Ludwig Witgenstein, who himself may have struggled with the dangers of madness that comes from intellectualizing alone, cut off from concrete social life around him. The author suggests that much of the inner experience of self-dissocation, and confusion of subjective and objective dimensions, and bizarre magical thoughts, can be characterized by analogy to a philosophical position that Wittgenstein characterized in different ways as solipsism, or as private language - both of which Wittgenstein argued threatened to dissolve into incoherence.
In a sense, the author proposes, this dangerous territory of solipsistic dissolution is exactly where the schizophrenic goes, cut off from practical life. Yet, the "smile" of the schizophrenic tends to show an ironic awareness of the difference in order of "reality" between imagination and material facts.
This is a very different take from, on the one one hand, more taxonomical approaches to schizophrenia (for example in the DSM-IV), and on the other hand, more romantic approaches that characterize madness as a sort of Dionysian attempt to return to mystical, pre-linguistic childhood. Instead, the author argues that schizophrenia -- which emerges only after adolescence sets in - is an "Appolinian" disease of intellection and thought gone awry.
By making the insane writings of Daniel Schreber accessible, this book shows how a medical establishment may underestimate the intelligence and grasp of reality the patient has -- as well as how this madness as a disorder of thought can emanate an aura of quasi-spiritualism.
The other reviews of this book are perfect, including the one in German, and the lack of ability to read German does not prevent me from knowing that I know what it says.
An alternative viewpoint (than say Freud or Jaynes) for understanding behaviors associated with schizophrenia based on the "anti-"philosophy of later Wittgenstein.