Perhaps the best examples of such distortions are found in the so-called first-rank symptoms of schizophrenia, a set of specific hallucinations and delusions that the psychiatrist Kurt Schneider, a disciple of Jaspers, believed to be especially characteristic of schizophrenic patients.
The first-rank symptoms include various hallucinations or delusions in which patients lose a normal sense of owning or controlling their actions, sensations, or thoughts-as when patients feel that all their inner experiences are under the control or scrutiny of some other being, or even that someone other than themselves is actually thinking their thoughts or looking out through their very eyes.
"Then I realized why I was studying his face so closely," writes Barbara O'Brien in Operators and Things, an autobiographical account of her schizophrenic illness. "Hinton was tuned in on my mind and was studying the analyst's face through my eyes."
Schizophrenic patients may also believe, for instance, that what appear to be other human beings are really phantoms or cleverly designed machines quite devoid of any real consciousness, or that the entire universe is responding to each peristaltic movement of their intestines.
Jaspers speaks of "metaphysical delusions" that reflect experience of a shattering of the self, or a sense that the universe itself is in some imminent danger or has even ceased to exist. Schizophrenics may believe that they have invented everything they encounter-that, for example, they themselves have invented the story they have just read.
One patient claimed that he used to be a drawing in a book but had finally escaped and come to the hospital. Another declared that he contained within his own body all the heavenly bodies while also maintaining that these heavenly bodies simultaneously existed in the outer world. Such delusions are not explicable as wish-fulfillment fantasies-at least not readily so-for even if they do, at some level, involve intense wishes, the wishes themselves seem in need of considerable elucidation before they can be empathically understood or can play an explanatory role.
Nor is the characteristic tone or atmosphere of many such delusions consistent with the psychoanalytic interpretation of regression to a primitive or Dionysian form of consciousness. For one thing, the famous "flat affect" observed in so many schizophrenics, as well as the devitalized and derealized quality that often permeates their experiential world, hardly suggests a regressed state charged with the energy and vitality of the primary process.
According to Eugen Bleuler, "schizophrenics can write whole autobiographies without manifesting the least bit of emotion. They will describe their suffering and their actions as if it were a theme in physics.'
The Paradoxes of Delusion Louis A. Sass
