The thickness of being: intentional worlds, strategies of identity, and experience among schizophrenics

Abstract

In recent years, researchers have explored the subjective experience of patients diagnosed as schizophrenic and its transformation throughout the course of schizophrenia. Experience is a complex, nontransparent reality that escapes direct, empathic understanding. Concepts and methods developed by European psychiatric phenomenology and by Ricoeur's hermeneutics are used for discussing data collected in Montréal with patients diagnosed as schizophrenic. Persons who differ for their rate of rehospitalization during the last 4 years are compared on various indices of social integration and for their subjective "life-world". Data indicate the importance of "positive withdrawal" for nonrehospitalizated patients and enlighten its subjective significance. Patients' narrative reveal how distancing and relating elements are interwoven in their life history. Self-descriptions bring out the semantic and stylistic strategies used to construct a narrative identity. They illustrate the range of strategies patients use to distance themselves from a static, objectified characterization of themselves. Data indicate the importance of understanding patients' experience from the perspectives developed by European phenomenological psychiatry. This invites the reevaluation of the very notion of coping and its expansion on the basis of a broader approach to the notion of experience. Hypotheses are drawn regarding the role of cultural and social factors in shaping a position of "positive withdrawal".