Tuesday, March 30, 2021

Philosophy has discovered that the mentally ill are people - seriously!

The paper entitled 'I Am Schizophrenic, Believe It or Not!: A Dialogue about the Importance of Recognition' by Gilardi & Stanghellini (2021a) must be a major publication if it warrants 6 commentaries (from Brencio (2021), Fulford (2021), Banicki (2021), Bergqvist (2021), Flanagan (2021) and Myers (2021)). Understandably, Gilardi & Stanghellini (2021b) were given a chance to reply.

However, I can't quite see what the value of the paper is. Obviously, mentally ill people may want recognition. However, most people who have experienced a schizophrenic illness don't see themselves as mentally ill, at least at the time of the episode. I'm not saying there's no value in thinking psychodynamically about psychosis (eg. see my book review), but quite a few 'schizophrenics' are not interested in psychotherapy. And I’m not undermining the value of psychotherapy for those that want it (eg. see my talk).

Of course dialetical recognition is needed in therapy. But is this as far as the philosophy of psychiatry and psychology has got after all these years? Or am I missing something?


Richard Gipps said...

The context the paper addresses is that of the schizophrenic patient coming for psychotherapy.

The paper continues the Jasperian tradition of achieving and offering a phenomenologically astute characterisation of schizophrenia: of the reality of it, the devastation to the unity of the psyche, unity of the mind and body, connection to the world and to others, loss of automatic know-how, etc.

The recognition of which it speaks is of the patient in her illness. An honest recognition of the illness - rather than the well-meaning evasions of addressing the actual fact of schizophrenic inner life by many psychologists. And a recognition offered to the patient in her grief about her uprootedness. And a recognition of the allure of psychotic life, of the emotionally protective as well as the emotionally damaging nature of schizophrenic loneliness.

A key idea offered in the paper is that this recognition is essential to the painful task of Aufhebung - i.e. of healing the inner splits.

It is, I think, not at all easy to offer recognition to someone. It's easy to say things like 'treat them as a person, not as a body' etc. But what does it really mean, in fact, to treat this person, here, now, as a person? What is to be acknowledged? And what form does the acknowledgement look like?

DBDouble said...

Of course, I agree, Richard, that it is not easy to offer recognition to someone. That does need saying. But I don't see how the paper and the commentaries have taken that forward. As I said, what am I missing?

Anonymous said...

I am called She. I have schizophrenia. I am late to this but... maybe you do not offer recognition at all, for that is a strange thing to offer, like offering "seeing". Surely seeing is inevitable in close proximity. Perhaps you mean you offer validation. But I have a suspiscion about the word "offer". Do you have to "offer?". Do you have to be the giver or the doer? Does the schizophrenic have to be the acceptor and the done to? I am schizophrenic and my persecuting voices impose their "offers" on me night and day. I dare say they try to offer me "recognition" but what I what I would feel surprised by is someone recognizing this much about how everything in the schizophrenics world is pressing in on him or her and the schizophrenic themselves gets very little space or hours in the day to recognize themself beneath all of that influx and bombardment. And so the schizophrenic may want help for themselves to recognize themself in that interior mayhem but equally recognize how hard that chaos is to live with, and maybe have other people recognize both those things also. And in their recognizing it offer nothing, the way you offer nothing to someone whose family has just been demolished in a missile strike. You maybe say nothing, since the acknowledgement there is little you can say to such a picture of misery is quite possibly the most profound and rare and lovliest healing you can offer. But only the very courageous offer their powerlessness. Schizophrenics like the courageously powerless, because this is what they are.