Double bookkeeping and schizophrenia spectrum: divided unified phenomenal consciousness.
Josef Parnas, Annick Urfer-Parnas, Helene Stephensen
European Archives of Psychiatry and Clinical Neuroscience December 1, 2021 DOI: 10.1007/s00406-020-01185-0 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Keywords | Auto-affection Consciousness Double bookkeeping Schizophrenia spectrum Self-disorders |
| Citations | 59 |
| Key points | Proposes that double bookkeeping manifests across various psychotic phenomena and its antecedent may be observed in premorbid phases and schizotypal disorder, with a phenomenological analysis suggesting an instability in the affective articulation of selfhood. |
Abstract
Eugen Bleuler, the founder of the concept of schizophrenia, pointed out that psychotic patients were able to live in two disjoint worlds (namely, the social, intersubjective world and the delusional world). He termed this phenomenon "double bookkeeping," but did not provide any conceptual elaboration of this phenomenon or its possible mechanisms. Double bookkeeping has been neglected in mainstream psychiatry, but it has been addressed in recent theoretical work, however mainly concerned with the issue of delusion. In this article, we present clinical material that supports the view that double bookkeeping manifests itself across various psychotic phenomena and its antecedent may be observed in premorbid (pre-onset) phases as well as in the schizotypal disorder. We try to conceptualize double bookkeeping to concretize an often atmospheric perception of paradoxicality in the encounter with the patient. A phenomenological analysis of double bookkeeping suggests an instability in the affective ("auto-affection") articulation of selfhood. We point to four main implications of our presentation: (1) diagnostic, (2) epistemological, (3) therapeutic and (4) pathogenetic research.