Talking too much is a nuisance

SCHIZOPHREN I DISORDERS

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Disturbances of ego experience - disturbances of ego vitality - disturbances of ego activity - disturbances of ego consistency - disturbances of ego demarcation - disturbances of ego identity - etc.

Everyone knows of himself: I am me. This is called I-consciousness. But nobody talks about it because it is so natural. But not for sick people who suffer from a disorder of the ego-consciousness. This includes mostly schizophrenic people. For them, this natural phenomenon, wrong in the sick, is suddenly an existential threat, even if nobody notices what is going on here in terms of inner psychological danger. What you see are just incomprehensible, bizarre or seemingly absurd reactions. The cause remains undetected, yes, most of them do not even know how complicated the mental processes are and what consequently can derail due to illness and thus torment the person affected.

Therefore, the following is a brief overview of the topic of schizophrenic ego disorders.


Mentioned technical terms:
Schizophrenia - schizophrenic ego disturbances - "split insanity" - disturbances of the ego experience - ego consciousness - consciousness of myself - depersonalization - derealization - ego vitality - ego activity - ego consistency - ego demarcation - ego - Identity - stupor - mutism - tearing off thoughts - blocking thoughts - confusion of thought - syllable repetition - word repetition - echo-like repetition - echolalia - echo practice - stereotypical movement patterns - grimacing - state of excitement - delusional influence - confusion - madness - inner psychological chaos - psychopathology - etc.

No mental illness, probably no suffering at all, provokes as much negative interest in the general public as schizophrenia: insecurity, perplexity, embarrassment, fear, shame, even irritable reactions and aggressiveness. This is probably the longest known and most intensely investigated mental disorder.

But most people can hardly associate anything concrete with a schizophrenic illness, apart from the common but unhelpful phrase of "splitting insanity". This may be followed by hallucinations, delusions and - somewhat embarrassed - the feared violence, which is known from rare but memorable individual cases (and which sometimes seems to come in handy for some forms of the media).

But what makes up the less spectacular but no less debilitating symptoms remains hidden to most. But that is exactly what would be important in order to obtain your knowledge not only from third parties, from rumors and media reports - with all the disadvantages. And above all to do justice to a disease that not only affects around one million people in the German-speaking area and thus around 60 million on this earth, but is largely inconspicuous to the outside world in the majority of those affected. But that also means that the schizophrenic sufferers mainly "internally". Here there are indeed signs of illness - admittedly - that are barely comprehensible with "common sense". For details, see the detailed chapter on schizophrenia.

Schizophrenic ego disorders

Above all, this includes the Disorders of the ego experience, also as schizophrenic ego disorders designated. But whoever deals a little with them comes closer to the nature of the schizophrenic illness and understands some "craziness" from an external point of view as well as the inner pain of those affected a little better. In detail:

One of the phenomena characteristic of schizophrenia is the feeling of being influenced and controlled by external forces in thinking, acting and feeling. That is also what characterizes these ego disorders. The own inner soul processes are experienced as being made, directed and influenced by others and outside. Everything that happens inside them no longer belongs to them. The connection to her self has been lost. The barrier between the ego and the environment that is open to everyone has become permeable. One can "walk in and out", one has become "public fair game", at the same time a "transparent person in the spiritual realm".

And not only this: The environment can not only see, hear and feel everything, you can also manipulate the person affected: The patient has become a plaything, a puppet for others. Of course, everything only in his pathological experience, but that is completely sufficient to steer this life into unhappy paths or even to destroy it.

What do we mean by I?

And here something should be made up in an explanatory way, which is basically clear to everyone and therefore not a big topic: Nothing is easier for a healthy person than to say: "I am me, what is the point of the stupid question". Because there is hardly a word that we use as often as this Ieven if one is not an egoist. Everyone is certain of their own personal identity. And yet there is hardly a term as difficult to define as this "I". It is not a uniform concept, not a concrete thing, but a construction from different theories, each of which has its own specific purpose or function.

For everyday language use and for our healthy feeling and self-esteem, this "I am" means that I am lively, uniform and cohesive in nature, that I am able to demarcate and differentiate myself from other beings and things, that I am independent and my knowledge and Classify things around me and determine my own actions. In short: that I can be myself - in every situation in life. So much for this somewhat philosophical opening credits. Why? Because it no longer applies to the schizophrenic patient.

For him the whole thing is not a theoretical or philosophical question; for him it becomes simply a question of existence. An existential question is usually understood to be an economic, especially financial, threat. But it can also be a threat from within. Only nobody cares, although this is an even more existential danger. When someone loses his economic foundation, everyone is full of compassion. If someone loses his psychological foundation, he cannot count on any help, he is even labeled as "crazy".

The basis of being human: I-consciousness

So the ego is a general term for the "core" or "structure" of a personality. The so-called basis of a human existence is then I-consciousness. That is the certainty of the awake, clear-conscious person: "I am myself". It is important to know: We are not conscious, but are self-confident. We to have not an ego-consciousness, but rather are I-consciousness par excellence. We to have not an me, but are even this self.

That sounds banal, but if you think about it, you know why this phenomenon: that Awareness of myself is so elusive. You don't just stand in front of yourself while observing, you are yourself this self.

This somewhat complicated phenomenon becomes clear, however, especially when the ego-consciousness does not function normally, i.e. when Disorders of self-awareness are present. These are, for example, depersonalization, derealization, disturbances of ego vitality, ego activity, ego consistency and ego coherence, ego demarcation, ego identity, self image (self concept, personality image) and ego strength.

Therefore, the following is a brief overview of this topic: For a more detailed description, see the special chapter Disorders of self-awareness.

Schizophrenic ego disorders

Disturbances of the ego-consciousness can occur with various clinical pictures (certain personality disorders and neurotic developments, depression, manic high spirits, organic brain psychosyndromes, intoxication psychoses ("intoxication madness"), epileptic psychoses, etc. - and of course with schizophrenia.

The following is a brief overview of the most difficult to grasp and for those affected probably also the most agonizing ego disorders in the context of a schizophrenic illness in key words:

- Disturbances in ego activity: In a lighter form, only speaking and movements are inhibited, slowed down, slow and slow, everything is made difficult and delayed. As a result, the person concerned appears slowed down in facial expressions and gestures, ungracious, sedate, mannered (graceful, artificial), maybe even bizarre. In extreme cases, he is mentally, mentally and physically blocked (technical term: stupor) and no longer speaks (mutism).

Fear and panic sometimes lead to overcompensation: stereotypical movement patterns, imitating the movement of others (echopraxia). Or trying to break through this blockage with strange or extreme measures: grimacing, arousal, etc.

Thinking and feeling can also be affected: memory and concentration disorders up to absent-mindedness, ultimately even tearing off or blocking thoughts or total confusion of thought.

The speaking seems choppy, erratic, changing in volume and tempo. Sometimes up to pointless repetition of syllables or words or echo-like repetition (echolalia).

- Disorders of ego demarcation: "I can no longer shield myself, demarcate (= demarcate), do not know where to stop, am unprotected, can no longer distinguish the outside from the inside, everything penetrates into me, through me". Or: "My thoughts spread everywhere and can be read by others", "suddenly everyone knows about my most intimate wishes".

This means that the I boundaries (here I am and there you are) are riddled with holes and the person concerned is exposed to his environment without protection (like a state whose borders can suddenly no longer be protected by its own security forces).

But not only that: The uncontrolled exchange is reciprocal, i.e. foreign thoughts, impulses, moods and even instructions for action are entered (technical term: external influence delusion). Or: "What others think carries over to me."

Again the strangest reactions result inevitably, which the unsuspecting environment cannot interpret and therefore alienate the, fear and horror can spread.

- Disorders of the ego identity: "Am I still myself?" Or: "I am no longer myself, am not me, must not be who I am." Or more specifically: "I have - or do I have a different nose, different eyes, a strange mouth, different ears, hair?" "Have I changed, am man and woman at the same time, am I different on the right and on the left?"

This ego-identity uncertainty naturally also leads to bizarre reactions, stereotypical self-assurances or even conjurations. Or the delusion imposes itself as an apparent solution (the old identity is lost and has to be replaced by a new one: e.g. paternity, maternity, descent delusion, etc.).

- Disturbances of the ego-consistency correspond most closely to what is generally understood by "splitting insanity", ie the schizophrenic patient feels torn, splintered, split, disintegrated, fragmented, broken, halved, perforated, as a viscous mass, scattered to the wind, etc.

But when the ego is completely torn apart, mind, feeling, mood, thoughts and other experiences no longer fit together. Such a "chaos" threatens the most contradicting emotions and seemingly absurd reactions.

- Disorders of ego vitality: "Am I still alive"? "Am I still at all"? "I don't feel like I'm alive anymore". "I am afraid that life will go away from me, that I will perish, die or even rot". "I'm already dead, turned to dust" and others

conclusion

Explaining ego disturbances is difficult; Enduring ego disturbances is a fate that is hard to describe. Above all, you can't talk to anyone. Anyone who wants to hear something like this can understand it, and certainly not mitigate it. And then: do you even know under these conditions who you can trust?

In any case, it becomes clear that numerous other impairments can arise from the ego disturbances: astonishment, excitement, self and external aggressiveness, delusional states in any form, confusion, peculiarities in thinking, speaking, acting, the most contradicting emotional reactions, in short: how should do you react differently in this crazy inner world than like a "madman"?

Therefore - if one is given the gift of understanding, depending on good will, compassion, patience and level of information - one should also deal with schizophrenic patients more patiently, more indulgently, perhaps even more helpfully than is often the case. Admittedly, some illnesses do not make it easy for relatives, colleagues, neighbors, etc. But just imagine a series of symptoms as incomprehensible as the ego disorders discussed here. This is only a small selection of the schizophrenic clinical picture, as you can read in the corresponding chapter on schizophrenia.

The schizophrenic ego disorders are, however, something special: largely unknown and therefore not understood - and extremely excruciating for those affected, precisely because no one can understand them.

literature

For details, see the extensive Internet chapter on schizophrenia with a corresponding bibliography including a selection of books that is easy to understand. The present statements are primarily based on

Scharfetter, C.: General psychopathology. Thieme-Verlag, Stuttgart-New York 1996

Scharfetter, C.: Schizophrenic people. Beltz-Verlag, Weinheim-New York 1995