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Clinical Judgment of Schizophrenia: Praecox Feeling and the Bizarreness of Contact—Open Controversies

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The Clinician in the Psychiatric Diagnostic Process

Abstract

The Praecox Feeling (PF) is a specific experience that arises in a psychiatrist in the encounter with a person with schizophrenia. It is classically described as an atmospheric feeling of strangeness and unease. Several studies have shown that psychiatrists take this subjective experience seriously into consideration in diagnosis. However, this phenomenon is still relatively poorly understood. This chapter begins with a presentation of several historical expositions of the PF understood as a sensation, intuition, impression, and experience, alongside the evolution of the concept of schizophrenia that shows the epistemological entanglement of these two notions. Next, it discusses some recent empirical evidence concerning the PF’s reliability, sensitivity, and specificity. In the last part, the chapter proposes a new phenomenological conceptualization of the PF. The model of the temporal unfolding of the PF takes advantage of Husserl’s work on intersubjectivity and Straus’ concept of aesthetic sensing. It accounts for the paradox of the PF as both lived evidence and indescribable experience. The PF is a complex cognitive and embodied process based upon ante-predicative aesthetic sensing (the bizarreness of contact corresponding to the primary, inchoate, and atmospheric experience of strangeness), which is secondly apprehended as perceptible evidence thanks to clinical typification. The PF is not rapid but extended in time, and it requires conscious, reflective operations for its validation, a critical attitude toward one’s “feelings” through operationalized confrontation with evidence. In conclusion, the chapter emphasizes the importance of the PF for the education of mental health professionals.

The sensing is to knowing as a cry is to words.

Erwin Straus (1963, p. 312)

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Author information

Authors and Affiliations

  1. Philosophy of Mental Health Unit, Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, Poznan, Poland

    Marcin Moskalewicz

  2. Department of Psychiatry, Psychotherapies and Art-therapy, Toulouse University Hospital, Toulouse, France

    Tudi Gozé

  3. Equipe de Recherche sur les Rationalités Philosophiques et les Savoirs—EA3051, Université de Toulouse—Jean Jaurès, Toulouse, France

    Tudi Gozé

Authors
  1. Marcin Moskalewicz
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  2. Tudi Gozé
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Corresponding author

Correspondence to Marcin Moskalewicz .

Editor information

Editors and Affiliations

  1. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Massimo Biondi

  2. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy

    Angelo Picardi

  3. Community Service for Prevention and Early Intervention in Mental Health, Rome 1 Local Health Unit, Rome, Italy

    Mauro Pallagrosi

  4. National Institute of Training, Italian Psychoanalytic Society, Rome, Italy

    Laura Fonzi

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Moskalewicz, M., Gozé, T. (2022). Clinical Judgment of Schizophrenia: Praecox Feeling and the Bizarreness of Contact—Open Controversies. In: Biondi, M., Picardi, A., Pallagrosi, M., Fonzi, L. (eds) The Clinician in the Psychiatric Diagnostic Process . Springer, Cham. https://doi.org/10.1007/978-3-030-90431-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-90431-9_9

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