> какая-нибудь литература про "людей без личности" в субпсихотическом состоянии

> Briefly, “perplexity” addresses a sense of lacking immersion in the world, lack of spontaneous grasping of commonsensical meanings, puzzlement, and alienation; “self-disorders” maps anomalies of pre-reflective self-awareness, i.e., of the tacit sense of existing as a self-coinciding subject of experience and action;

> we do think that in some cases, the use of (very) low-dose antipsychotic drugs can be immensely beneficial

> at an early stage even if used to dampen down the overwhelming feelings of

> uneasiness and anxiety. Psychological therapies, on the other hand, should perhaps

> aim at equipping the patient with adaptive coping strategies in order to deal with the

> distress caused by his experiences in the first instance instead of solely focusing on

> reorganising the patient’s thinking patterns or beliefs. Although the sense of

> perplexity and confusion in early psychosis as discussed in this chapter can be

> extremely resistant to intervention and change, if detected early enough, the

> individual might be able to learn the skills necessary to reorient himself and

> re-establish his self-world relationship with the right kinds of help which are

> determined on an individual basis.

> One workgroup gathered around Seikkula in Finland has developed a therapeutic

> approach called ‘open dialogue’ which appears to be based on similar ideas. They argue that

> therapy for psychosis should consists of a network of caregivers, family, and friends

> (Seikkula and Olson 2003). A voluntary social process (a so called ‘open dialogue’) is used to

> generate meaning for something that seems to go far beyond the explicable, namely psychotic

> experiences.

> A key point that I wish to make in this text is that schizophrenia is not just a disorder of

> one person, of one self, or of one brain. It is a disorder of self and intersubjectivity concerning

> how you and I directly and indirectly inter-relate. One could be tempted to conclude that

> schizophrenia is a disorder of the ‘relational self’, yet, this description would fail to grasp the

> ‘minimal aspect’ that the current self-disorder hypothesis targets.

> ну так что делать?

> мне лучше будет лечь и умереть, чем выздороветь с осознанием потери стольких лет жизни.

> чтобы рассказать то, что я чувствую, приходится записывать на бумажке и даже так мне не всегда удается выделить мысль, сформулировать в слова и донести до врача в том виде, в каком я записал, а не в том, как я понял потом собою же записанное

> да, я делаю все медленно и с трудом, постоянно отвлекаясь на кашу в голове

> терял суть рассуждения

> времени на сформулировать мысль очень много

> perplexity это позитивный симптом, часть психоза? или изменение личности?

> This loss of meaning or grip is frequently associated with an intense hyperreflexivity, i.e., an excessive tendency to monitor, and thereby objectify, one's own experiences and actions.

> This hyperreflexive tendency can in part be interpreted as an attempt at compensation, as a (futile) attempt at restoring something that has been lost.

> The autistic disorders of meaning, self-awareness, and intersubjectivity occur in the majority of the first-onset schizophrenia spectrum cases (17). In fact, these core experiential phenomena are particularly clear in their pure form mainly in the early illness stages (20). They become increasingly infused with content, and hence integrated and transformed in the emerging psychotic symptoms (30,31). It must be clear now that although the autistic features are sometimes treated on a par with the so-called "negative symptoms", the experiential anomalies and disorders so far described cannot be adequately comprehended as mechanic lacks or functional fall-outs. Rather they testify to a complex and profound reorganization of subjectivity, often populated, from the patient's perspective, with quite "positive" experiential anomalies.

> Alternatively, the loss of commonsense can be resulted from a sense of distrust and scepticism against intuition or an obsessional emphasis on rationality (for a fascinating study on logic and psychosis, see Owen et al.2007). The latter approach implies the pathological process is actively willed by the patient (‘an active and voluntary bracketing of commonsense’), and this may indeed seem to be the case in Laurie’s account, at least duringthe very first stage of her psychosis. The extreme scepticism towards everyday experience is a top-down process which destroys the intuitive nature of commonsense and shifts more towards a ‘morbid rationalism’ or even an ‘apoplexia philosophica’ (interestingly, the word ‘apoplexy’ is also used in medicine as aterm for internal bleeding) which quite literally paralyses the patient into a catatonic state because what is originally a coping strategy against the perplexity of reality by creating new rules (rather similar to Laurie’s storyboards) has turned into a distorted, purely intellectualistic nihilism where the world is made of thoughts alone, and thus life in this world can no longer be lived within corporeality.

> Indeed to us,the loss of common sense underlying feelings of perplexity on both perceptual and cognitive levels is the most subtle yet most significant indicator of a severely disturbed self which lies at the core of the phenomenology of psychosis and which signals the start of the prodromal stage (in other words, an even earlier stage before ‘Trema’).

> психотерапией не лечат же бредовых больных.