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Dialogue with schizophrenics statements not derived from inner experiences

Dialogue with schizophrenics statements not derived from inner experiences

Seishin Shinkeigaku Zasshi 102(6): 543-559

ISSN/ISBN: 0033-2658

PMID: 10979315

When we examine the psychopathological issues of schizophrenia, we usually try to find clues in patients' statements spoken in dialogic situations. However, if we take into account that schizophrenic changes are supposed to contain various degrees of difficulties in inter-subjectivity, we must discuss first how and to what extent such patients are expressing themselves and communicating to us. The purpose of the present study was to determine the characteristics of dialogues between psychiatrists and schizophrenic patients and to consider the relationship of the communication to the patients' inner experiences. In order to discuss these problems, the authors made a study of 3 schizophrenic patients who had been in highly deteriorated mental states but managed to express themselves. The clinical characteristics of these patients were as follows: 1) First, the patients had been quite at a loss for words and remained silent. However, if the therapist carefully attended them and helped them express their feelings, they began to speak slowly. 2) However, shortly after they had finished expressing something, they often complained that they could not look backward or they did not know anything about what had been expressed even when there were no defects of memory. 3) The patients did not know what their inner experiences were until they had been asked back again and again about their experiences by the therapist. In other words, they could encounter their inner worlds only through the intervention of the therapist. These clinical observations maintain the following interpretations: 1) The patients' expressions did not pass into their own possession and had derivation from their inner experiences. 2) From a phenomenological point of view, this was apparently related to the disunion between 'expressing selves' and 'experienced selves.' 3) Through the therapeutic dialogues, their experiences came up to the inter-subjective dimension, which led them to create their inner experiences.

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