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L'Evolution psychiatrique v.83 no.1, 2018년, pp.77 - 85   SSCI
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Hyper reflexivity and the first-person perspective: A decisive contribution of contemporary phenomenological psychopathology to the understanding of schizophrenia
Hyper-rEflexivitE et perspective en premiEre personne : un apport dEcisif de la psychopathologie phEnomEnologique contemporaine A la comprEhension de la schizophrEnie

Englebert, Jérôme (Département de psychologie, université ) ; Stanghellini, Giovanni (de Liège, bâtiment B33 Quartier-Agora, place des Orateurs 1, 4000 Liège, Belgique ) ; Valentiny, Caroline (Université ) ; Follet, Valérie (“G. d'Annunzio” de Chieti, Via Dei Vestini, 66100 Chieti, Italie ) ; Fuchs, Thomas (Département de psychologie, université ) ; Sass, Louis (de Liège, bâtiment B33 Quartier-Agora, place des Orateurs 1, 4000 Liège, Belgique ) ;
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    Abstract Objectives This paper considers the hypothesis of schizophrenic hyper reflexivity, which originates in the field of phenomenological psychopathology. It discusses the methodological context enabling these highly subjective manifestations to emerge. Starting from the seminal hypothesis developed by contemporary psychopathology that schizophrenic patients experience a form of consciousness that finds itself forced to question phenomena that should be intuitively self-evident, the idea of the present paper is to complete the usual interpretation of schizophrenia as a deficit by the hypothesis of an excessive functioning of consciousness. Methods The first-person perspective is a qualitative approach completing the third-person interpretation, traditional in the field of psychiatry, which consists in the attribution, from an external position, of clinical signs noted independently from the perceptions expressed by the patient. The first-person perspective focuses on the patient's subjective experience as expressed by that individual. To understand schizophrenia according to this perspective, the narratives of several schizophrenic patients were collected in a clinical setting. We used the EASE scale ( Examination of Anomalous Self-Experience ) for this purpose. This scale offers a phenomenologically-oriented semi-structured exploration of a set of difficulties revealing anomalies in subjective experience, considered as self-awareness disturbances. EASE was developed on the basis of self-descriptions by patients suffering from schizophrenic spectrum disorders. This tool enables the co-construction of a language between patient and clinician, focused on the patient's particular experiences and the unique phenomena he has to cope with. Results Alongside the hyper reflexivity phenomena, the qualitative analyses of the descriptions collected highlight two important features of schizophrenic being-in-the-world. First a common sense issue, which raises the question of inter-subjectivity and the scope for schizophrenic patients to share in a social world. Secondly, the existence of an intercorporeality disturbance, since the schizophrenic hyper reflexivity experiences are accompanied by a loss of the “common body”, the body being the scene where inter-subjectivity is played out. Discussion The use of the EASE scale and the application of the first-person perspective provides a relevant psychotherapeutic approach, both in the process of acknowledgement of the illness (required from the patient as well as from the clinician), and in communication with the families of schizophrenic patients. Conclusions The phenomenological interpretation provided by the application of a first-person perspective in the understanding of schizophrenic patients’ experiences, and the inclusion of hyper reflexivity phenomenon, suggest perspectives on schizophrenia that are no longer reduced to a mere interpretation of deficit (without denying the deficit), showing not a weakening, but a surprising intensification of consciousness.


    REsumE Objectifs Cet article prEsente l’hypothEse, issue du champ de la psychopathologie phEnomEnologique, de l’hyper-rEflexivitE schizophrEnique, selon laquelle les patients schizophrEnes sont pris dans l’expErimentation d’une conscience qui se retrouve contrainte d’interroger des phEnomEnes qui devraient aller intuitivement de soi. MEthodes La perspective en premiEre personne est une dEmarche qualitative complEtant la lecture, traditionnelle dans le champ de la psychiatrie, en troisiEme personne – qui consiste en l’attribution depuis une position externe de signes cliniques repErEs indEpendamment du ressenti exprimE par le patient. Cette perspective en premiEre personne concentre son attention sur l’expErience subjective qu’exprime le sujet. Le discours de plusieurs patients schizophrEnes a EtE recueilli dans le cadre d’un dispositif clinique en utilisant l’Echelle EASE ( Examination of Anomalous Self-Experience ). Cette Echelle permet l’exploration semi-structurEe, d’orientation phEnomEnologique, d’une sErie de difficultEs rEvElatrices d’anomalies de l’expErience subjective. REsultats En plus des phEnomEnes d’hyper-rEflexivitE, nos analyses mettent en Evidence deux grandes caractEristiques de l’Etre-au-monde schizophrEnique. D’abord une problEmatique du sens commun, qui pose la question de l’intersubjectivitE. Ensuite l’existence d’un trouble de l’intercorporEitE, les expEriences d’hyper-rEflexivitE schizophrEnique s’accompagnant d’une perte du ≪ corps commun ≫. Discussion L’application d’une perspective en premiEre personne dans la comprEhension du vEcu des patients schizophrEnes, ainsi que l’intErEt portE au phEnomEne d’hyper-rEflexivitE, permettent de proposer une vision de la schizophrEnie qui n’est plus rEduite A une lecture dEficitaire de celle-ci (sans nier cette derniEre), et qui dEcouvre non pas un affaiblissement, mais une intensification de la conscience. Conclusions La prise en considEration de la dimension tacite de l’existence schizophrEnique, telle que le suggEre la psychopathologie phEnomEnologique contemporaine, offre de prEcieuses informations A la pratique clinique et suggEre d’importantes perspectives de recherche associant aux designs mEthodologiques conventionnels des perspectives novatrices et prometteuses.


  • 주제어

    Schizophrénie .   Hyper-réflexivité .   Perspective en première personne .   EASE .   Intersubjectivité .   Schizophrenia .   Hyper reflexivity .   First-person perspective .   EASE .   Inter-subjectivity.  

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