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CONCEPTUAL ANALYSIS article
Front. Psychiatry
Sec. Psychopathology
Volume 15 - 2024 |
doi: 10.3389/fpsyt.2024.1445615
This article is part of the Research Topic Sensing Minds: On the Role of Intuitions, Feelings, and Emotions in Psy-clinical Diagnoses and Judgements View all articles
Close, Yet So Far Away: A Phenomenology of the Praecox Feeling in the Diagnosis of Schizophrenia as Intercorporeal Alienness
Provisionally accepted- 1 Heidelberg University, Heidelberg, Germany
- 2 Poznan University of Medical Sciences, Poznań, Greater Poland, Poland
- 3 Marie Curie-Sklodowska University, Lublin, Lublin Voivodeship, Poland
- 4 IDEAS NCBR Ltd., Warsaw, Masovian, Poland
- 5 Texas A and M University, College Station, Texas, United States
- 6 Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany
Debates concerning the reliability and validity of operationalized criteria and diagnostic tools have surrounded the issue of schizophrenia diagnosis and clinical decision-making related to the disorder. The notion of the Praecox Feeling (PF) has played a prominent role in the discussions as an example of the possibility of a rapid and potentially valid diagnosis based solely on "intuition" or a peculiar emotional experience or impression arising in a physician during an interaction with a patient with schizophrenia. In this paper, we argue that PF is enabled by the (phenomenologically understood) intercorporeal dimension of the clinical encounter. Intercorporeality in this sense denotes intertwinement between embodied expressions that may lead to feelings of connection but also, as in the case of PF, of disconnection and strangeness -the experience of alienness. Following Waldenfels, alienness ranges from the average social encounter to more extreme and peculiar forms such as PF. To prove our point, we analyze the metaphors used by physicians in various cultural contexts (the United States, the United Kingdom, and Poland) to express the apparently ineffable experience of the PF. We focus on two dominant metaphors of distance, the first expressing spatial distance by referring to an "object in-between" the physician and the patient, and the second expressing mental distance by referring to the "other-worldliness" of the patient. We interpret the object in-between metaphors as reflecting the sense of separateness and the other-worldliness metaphors as reflecting the sense of strangeness, with both meanings unified in the notion of "close remoteness". Such unsettling but speculation-provoking feeling of close remoteness may be rendered by the concept of "the eerie" (Mark Fisher). We conclude that metaphor and phenomenological analysis facilitate an understanding of the experiential profile of PF in the clinical encounter, outlining relevant clinical implications.
Keywords: Praecox feeling, Phenomenological psychopathology, Alienness, metaphor, clinical decision-making, Diagnostic Techniques and Procedures, embodiment, Intercorporeality
Received: 07 Jun 2024; Accepted: 03 Sep 2024.
Copyright: © 2024 Vial, Moskalewicz, Szuła, Schwartz and Fuchs. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Marcin Moskalewicz, Heidelberg University, Heidelberg, Germany
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