Phenomenology of Receding Delusions

Abstract

In this presentation a phenomenological perspective on ongoing and receding delusions in persons with schizophrenia will be discussed. Drawing both on an in-depth interview-study as well as clinical cases the diverse manners of recovering from (or even with) delusions will be discussed. While some patients recover from delusions including a critical stance towards their own delusional experiences, others recover from delusions while maintaining the conviction that their past delusions might have contained some truth, and yet other patients maintain a double orientation to reality and thus recover, more or less, with delusions. A fine-grained, phenomenologically-informed stage model of receding delusions (called orthostrophe) will be presented, integrating both the anomalous experience and basic reasoning deficit hypothesis. In this model, drawing partially on Conrad's account to upcoming deluions, we will also highlight the concept of psychosis as a loss, or at least profound, alteration of common-sensical habitualities. Some clinical implications for treatment of persons with schizophrenia in their acute and post-acute stages will be discussed, focusing on the diversity of recovery from illness episodes regarding delusions and suggesting different styles of intervention for long-term recovery.