The Social, the Outer and the Reflexive: Some More Dimensions of Subjectivity, Schizophrenia, and Its Recovery

The Social, the Outer and the ReflexiveSome More Dimensions of Subjectivity, Schizophrenia, and Its Recovery The author reports no conflicts of interest. First of all, I want to express my gratitude to the Association for the Advancement of Philosophy and Psychiatry, Philosophy, Psychiatry, & Psychology, and the Karl Jaspers Award Committee for their recognition of my paper "Institution or individuality? Some reflections on the lessons to be learned from personal accounts of recovery from schizophrenia" (Wannberg, 2024). I am also very thankful for Dr. Paul B. Lieberman's (2024) and Pr. Elizabeth Pienkos' (2024) stimulating comments on the paper. In the original paper, I used the case of the first person accounts of recovery from schizophrenia as a paradigm to elucidate the components of subjectivity more generally, as well as their logical relations. My main point was that considering the "recovery claim" as potentially endowed with a meaning sufficiently close to the official definition of the "personal" sense of recovery at stake—that is, in brief, having "become oneself" despite recurring or residual symptoms—invites us to question current phenomenological, narrative and constructionist approaches of the self in psychopathology. By contrast to these, I stressed the need of a conception of the self more sensible to its social and interpersonal dimensions, which I attempted to sketch out notably by resorting to Wittgenstein's (1953/1997) idea of "grammar." I am very happy that both Lieberman and Pienkos see the appeal to the social as a welcome move with regard to prevailing approaches to schizophrenia and its recovery. But what does it really mean for the subjective or the individual to be socially and interpersonally constituted, and how are we to account for that? End Page 75 At a first glance, appealing to the social seems to be in line with current trends in psychopathology, including, as Pienkos points out, in the phenomenological tradition. She elsewhere announces a "shift in emphasis" currently taking place within phenomenological psychopathology, characterized by an increasing interest in the situated and dated aspects of subjectivity (Pienkos et al., 2023). This is a valuable turn. However, I am quite dubious that the well-known distinction between an "experiential" and a "narrative" self to which Pienkos appeals is apt to do all the conceptual work required to attain a satisfactory conception of the self and its social dimensions. In my original paper, I took the "recovery account" to challenge both these notions. As concerns the experiential dimension, I held that this type of account questions the phenomenologist's assumption that subjectivity is ultimately grounded in lived (self-)experience. Provided that typical symptoms of schizophrenia (e.g., thought insertion) are expressions of a disorder situated at this most "fundamental" level of the self and provided that they are stemming, at least according to one of the most widespread phenomenological models, from a trait-like disposition present before the onset of psychosis (e.g., Henriksen et al., 2019), it is quite natural to think that these symptoms persist in some form in the context of recovery (e.g., as intrusive thoughts or as "thoughts spoken out loud"). This is indeed the case for several of the authors "in recovery" in the Schizophrenia Bulletin's archives (e.g., Greenblat, 2000), which provided the main source of my analysis. But if this is so, we cannot see their recovery claim as an expression of a "whole" self, so to speak. So we must either say that "personal" recovery from schizophrenia is an illusion or a contradiction, or else we must revise the foundational status of the experiential dimension (other possible options are left aside for the purposes of this brief comment). I argue for the revisionist option. For the equation between the subjective and the experiential does not only lead to an unwelcomed skepticism about the recovery account. There are also more straightforward philosophical reasons for refusing it. Wittgenstein (1980) made a first important step by inviting us to better take into account the variability of the psychological concepts. He notably made a crucial categorical distinction between "lived experiences" (like sensations and mental images) and "attitudes" (like beliefs and intentions) such that all concepts which, when used in the first person...