Chapter 2 the existential phenomenological foundations for the understanding of psychosis there is a further characteristic of the current psychiatric jargon it speaks of psychosis is a social or biological failure of adjustment or maladaptation of a particularly radical kind or loss of contact with reality or a lack of insight as vandenberg 1955 has said this jargon is a veritable.
Vocabulary of denigration the integration is not moralistic at least in a nineteenth-century sense in fact in many ways this language is the outcome of efforts to avoid thinking.
In terms of freedom choice responsibility but it implies a certain standard way of being human to which the psychotic cannot measure up I do not in fact object to all the implications in this vocabulary of denigration indeed I feel we should be more frank about the judgments we implicitly make when we call someone psychotic when I certify someone insane I’m not equivocating when I write that he is of unsound mind maybe dangerous to himself and others and requires care and attention.
In a mental hospital however at.
The same time I am also aware that in my opinion there are other people who are regarded as sane whose minds are as radically unsound who may be equally or more dangerous to themselves and others and whom society does not regard a psychotic and fit persons to be in a madhouse I am aware that the man who was said to be deluded maybe in his delusion telling me the truth and this in no equivocal or metaphorical sense.
But quite literally and that the cracked mind of the schizophrenic name let in light.
Which does not enter the intact.
Minds of many sane people whose minds are closed Ezequiel and Jasper’s opinion was a schizophrenic let’s confess here to a certain personal difficulty I have in being a psychiatrist.
Which lies behind a great deal of this book this is that except in the case of chronic schizophrenia I have difficulty in actually discovering the signs and.
Symptoms of psychosis in persons I and myself interviewing I used to think that this was some deficiency on my part that I was not clever enough to get it loose the nations and delusions and so on if I compared my experience with psychotics with the accounts given of psychosis and the standard textbooks I that the authors were not giving a description of.
The way these people behaved with me maybe they were right and that was wrong then I thought that maybe they were wrong but this is just as untenable the following seems to be a statement affect the standard texts contain the descriptions of the.
Behavior of people in a behavioral field that includes the psychiatrist the behavior of the patient is to some extent a function of the behavior of the psychiatrist in the same behavioral field the standard psychiatric patient is a function of the standard psychiatrist and of the standard mental hospital.
The figured base as it were which underscores all boilers great description of schizophrenics is his remark that when all is said and done they were stranger to him than the birds in his garden boiler we know approached his patients as a non psychiatric clinician would approach a clinical case with respect courtesy consideration and scientific curiosity the patient however is diseased in a medical sense and it is a matter of diagnosing his condition by observing the signs of his.
Disease this approach is regarded as so self-evidently justifiable by.
So many psychiatrists that they may find it difficult to know what I’m getting at there are now of course many other schools of thought but this is still the most extensive one in this country it certainly is the.
Approach that is taken for granted by non-medical people I am speaking here all the time.
Of psychotic patients ie as most people immediately say to.
Themselves not you or me psychiatrists still hang on to it in practice even though they pay lip service to incompatible views outlook and manner now there is so much that is good and worthwhile in this so much also that is safe in it that anyone has a right to examine most closely any view that a clinical professional attitude of this kind may not be all that is required or may even be misplaced in certain circumstances the difficulty consists not simply in noticing evidence of the patient’s feelings as they reveal.
Themselves in this behavior the good medical clinician will allow for the fact that if his patient is anxious his blood pressure may be somewhat higher than usual.
His pulse may be rather faster than normal and so on the.
Crux of the matter is that when one examines a heart or even the whole man as an organism one is not interested in the nature of one’s own personal feelings about him.
Are irrelevant discounted one maintains a more or less standard professional outlook and manner that the classical clinical psychiatric attitude has not changed in principle since crepin can be seen by comparing the following with the similar attitude of any recent British textbook of Psychiatry eg Meyer grosse Slater and Roth here is crepiness 1905 account.
To a lecture room of his students of a patient showing the signs of catatonic excitement quote the patient I will show you today has almost to be carried into the room as he walks in a straddling fashion on.
The outside of his feet I’m coming in he throws off his slippers sings a hymn loudly and then Christ twice in English my father my real father he is 18 years old and the pupil of the / real shul higher-grade.
Modern site school tall and rather strongly built but with a pale complexion on which there is very often a transient flush the patient sits with his eyes shut and pays no attention to his surroundings he does not look up even when he has spoken to but he answers beginning in the low voice and gradually screaming.
Louder and louder when asked where he is he says you want to know that too I tell you who was being measured and his measured and shall be measured I know all that and could tell you but I do not want to when asked his.
Name he screams what is your name what does he shut he shuts his eyes what does he hear he does.
Not understand he understands not how who where when what does he mean when I tell him to look he does not look properly.
You there just look what is it what is the matter attend he attends not I say what is it then why do you give me no answer are you getting.