STANGHELLINI AND BALLERINI / AUTISM: DISEMBODIED EXPERIENCE ■ 259

Key Concepts
Autism:
Disembodied Existence
Giovanni Stanghellini and
Massimo Ballerini

ABSTRACT: This paper considers the nature of schizo- (2002) in the diagnostic criteria for schizophre-
phrenic autism and urges its importance for under- nia adopted by the most important nosographic
standing the phenomenological core of schizophrenia. systems (American Psychiatric Association 2000;
Different clinical manifestations of schizophrenic au-
World Health Organization 1992).
tism are demonstrated, and it is asked whether these
might reflect different aspects of one underlying phe- Indeed, if the nosography of recent decades
nomenologically intelligible phenomenon. Four phe- has considered it feasible to abandon the concept
nomenological hypotheses are put forward: that autism of autism, as initially shaped by E. Bleuler (1911)
is a function of semantic drifting, emotional drifting, and Kretschmer (1921–1961), the same cannot
ontological incompleteness, or a particular ethic re- be said of phenomenological psychopathology
jecting common sense. By way of conclusion an inte- that has never ceased deploying it as an organiz-
grative hypothesis is considered: that autism is intelli-
er of the meaning of the conditions of existence
gible in terms of the experience of disembodiment.
that go under the name of schizophrenia
(Binswanger 1956; Blankenburg 1971; Minkows-
ki 1927; Mundt 1991; Parnas and Bovet 1991;
Serious aberrations in the use of the concept “autism” Sass 1992; Stanghellini 2000; Stanghellini 2004;
have brought much confusion into psychiatric discus- Tatossian 1984; Wyrsch 1949) (Table 1). The
sion. (Stroemgren 1969).
concept of autism, as elaborated by phenomeno-

C
AN WE RELINQUISH the concept of schizo- logical psychopathology, effectively describes the
phrenic autism, as suggested by a study schizophrenic eidos, that is the essential and sta-
of over thirty years ago, that was aimed ble psychopathological nucleus characterizing the
at simplifying psychiatric terminology, ridding it quality of the schizophrenic spectrum.
of all concepts seen as obsolete, vague, or con-
fusing? For sure, the supporters of a psychiatry Meaning Structures
based on simple, easy to reproduce, clinical con-
cepts would reply in the affirmative. And in fact Schizophrenic autism has many facets: it is a
schizophrenic autism has apparently vanished complex phenomenon that involves various as-
from mainstream psychiatry, becoming practically pects of the person and his or her cognitive,
impossible to come by, or has undergone a trans- conative, and emotional relationship with the
formation (as in the case of social and occupa- outside world. Its fundamental clinical aspects
tional dysfunction; see Stanghellini and Ballerini include detachment from interpersonal relations

© 2004 by The Johns Hopkins University Press

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Table 1. Genealogy of Autism: From Symptom to Meaning Structure

Bleuler (1911): Aut(erot)ism

Bleuler’s concept of autism relied on Freud’s notion of autoerotism and on associationist psychology. Autism is a
consequence of the splitting of psychic functions: a defense mechanism avoiding the conflicts between desires
and reality testing, promoting the shift to inner fantasy life. The following are the main characteristics of autis-
tic persons:

• Detachment from outer reality and the immersion in inner life.

• Disengagement from everyday activities (social withdrawal).
• Emotional indifference.
• Inappropriate behaviors.
• Dereistic and overinclusive thinking.

Kretschmer (1921): Emotional ataxia

Autism is the core feature of the schizothymic temperament, the personal disposition to schizoid personality
(psychopathic variant) and schizophrenia (psychosis). It is a kind of emotional ataxia whose main features are:

• Psychoesthesia or coldness, lack of affective contact with other persons mixed with irritability and hyper-
sensitivity to social stimuli.
• Social anxiety and avoidant behaviors.
• Hyperesthetic variant: hypersensible, cold but sensible aristocrat, pathetic idealist.
• Hypoesthetic variant: cold despotic, passionate-insensible, unstable vagabond.

Minkowsky (1927): Lack of the vital contact with reality

Autism is the trouble générateur (basic disorder) of schizophrenia. It is a global phenomenon (not a symptom),
a way of being whose essential feature is a pragmatic deficit (lack of the vital contact with reality):

• Autistic activity consists in the reduced capacity to interact with the external world.
• Autistic thought is characterized by its lack of communicative action.
• Autisme pauvre: negative features (like withdrawal) prevail.
• Autisme riche: positive features (like fantasy life) prevail.

Binswanger (1956): Miscarried existence

The meaning structures of autistic existence are described in an eidetic perspective as modes of anthropological
disproportion between height (or depth) and breadth:

• Verstiegenheit (exaltation): disproportion between the height of existential concerns and the breadth of
experience and understanding.
• Verschrobenheit (eccentricity, queerness): being à coté of the commonly shared world.
• Manieriertheit (mannerism): the impossibility of being oneself and the assimilation to a stereotyped model
of existence.

and trouble with empathy; the picture may be is necessary to delve down to the very roots of
limited to deficiencies (autisme pauvre [poor au- schizophrenia and so define its intrinsic essence.
tism]), or can be characterized by the prevailing The phenomenon of autism concerns a funda-
of idiosyncratic, odd and aloof mental activity mental aspect of existence: the ability to take
(Minkowski 1927). Is there such a thing as a part in social life, giving a sense to the others’
common denominator of the various clinical man- behaviors and to one’s existence according to the
ifestations of autism? To answer this question it horizon of meanings of the world surrounding
us. The contact with other individuals is a basic

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aspect of all out the lives, insomuch as the very Is it the effect of an irrepressible ethic option to
fact of being able to establish a spontaneous distance oneself from common sense and to take
contact with the people around us and the ability an eccentric stand in the face of the phenomenon
of existence?
to communicate through a common symbolic
register are essential elements in the existence of These are four possible answers as to the mean-
us all. ing organizer of autism, each of which affords a
The phenomenon of autism implies a fracture perspective from which to observe normal psy-
in social life, which is therefore compromised in chic activity and its psychopathologic distortions:
both of the two moments that make it up: (1) the the cognitive categorization process, the social
ability to recognize others as individuals endowed syntonization process, the Self setting-up process
with mental life (emotions, thoughts, feelings of and the establishment of values (Table 2).
affection) having a structure basically similar to Each perspective attempts to shed light on the
our own, and (2) the possibility to understand type of bond that links each individual to the
other people by means of prereflective and non- social world and also represents a perspective
propositional attunement with the expressions through which one can discern the polysemic
of their mental life and by means of a keyboard nature of the concept of common sense, a basic
of shared symbols and experiences. phenomenon, usually plain, but a genuine mile-
The emotional capability to view others as stone and condition to the possibility of social
people like ourselves, to establish interpersonal life (see Gadamer 1960). Each perspective does
relations with them intuitively and spontaneous- not—in itself—exclude the others: in the last
ly, and the ability to communicate according to section we shall propose an integration.
common codes: together, the social world as ho-
rizon of one’s own initiatives and one’s own The Cognitive-Categorical Dimension
plans for life, undergoes, through autism, a gro- Individual subjectivity is the organizational
tesque and paradoxical distortion. pole of cognitive processes that aim at classifying
The world of schizophrenic autism is charac- the phenomena of experience in significant rep-
terized by the progressive removal of other indi- resentations, necessary and indeed essential for
viduals from the category of living-conscious be- an individual’s orientation in his or her social
ings, up to a mechanical objectivization of the surroundings.
Other and an impersonal and algorithmic con- Man, as Schutz (1962a) writes, is an animal
ception of social life (Cutting 1999; Stanghellini symbolicum and his fundamental characteristic
2004). is the act of conceptualizing reality, by which he
Schizophrenic autism cancels the social char- applies a meaning to his own experience. This
acter of the human experience; the individual performance may take place in an explicit or
fluctuates in an idios kosmos (private world), far thematic manner (consciously, through reflec-
from the common intersubjective horizon. But tion), or else in an implicit or pre-thematic man-
how are we to understand its essential meaning ner (intuitively and automatically), as occurs dur-
structure? ing most of our everyday activities (Husserl 1959)
Is it a problem of semantic drifting, that is a decon- The characteristic feeling of objectivity of these
struction of the common symbolic register of mean- meanings is directly connected with their being
ings? shared by all individuals: meanings become ob-
Is it a problem of emotional drifting, that is a lack jective when they are shared by everyone, that is
of participation in the social world, in the “ever- when they have an intersubjective validity (Berg-
moving wave that engulfs us and without which
er and Luckmann 1966; Garfinkel 1967; Schutz
we could not live”?
1962b). All this enables us to live the phenomena
Is it a problem of ontological incompleteness, that
is the fragility of the tacit dimension of self-coher- of this world as solid reality.
ence that is at the base both of subjectivity and The totality of meanings shared by all individ-
intersubjectivity? uals in a certain social-cultural context forms a

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Table 2. Meaning Organizers of Autism: Basic Categories

Cognitive-categorization process
Semantic drifting: deconstruction of the common symbolic register of meanings

Social syntonization process

Emotional drifting: disturbed of emotional participation in the social world

Self setting-up process

Ontological incompleteness: fragility of the tacit dimension of self-coherence that is at the base both of
subjectivity and intersubjectivity

Establishment of values process

Antagonomic ethic option: choice to distance oneself from common sense and take an eccentric stand in the
face of the phenomenon of existence

network of symbols (Mead 1934). To be im- tions or achievable only through a deliberate
mersed in this order of interpretation is the es- effort. In this case, all the possible meanings of
sential premise to the phenomena of communi- whatsoever perceptive phenomenon, usually im-
cation and social interaction (Schutz 1964). This plicit, can present themselves explicitly to the
database of knowledge at everyone’s disposal, autistic person, as free associations totally de-
tacit and unquestioned, this common language, tached from the context: in other words the eval-
provided with culturally defined limits of exten- uation of significance and the criterion of rele-
sion, is one of the facets of the phenomenon of vance in respect to the situation go astray (Schutz
common sense. 1964). Schizophrenic phenomena provide the pic-
Schizophrenic autism involves a profound al- ture of an alien reality, in which facts, events,
teration to the symbolic register of socially shared and situations are organized according to a logic
meanings (Blankenburg 1969, 1971). Both the of a different quality from that existing in nor-
feeling of perplexity, that is the depths of doubt mal psychic life.
that occurs during the initial phases of schizo- The final result is grotesque. Schizophrenic
phrenia and the deviated behavior during the autism shatters the possibility of human interac-
premorbid and premonitory period are an ex- tion and paralyzes it in a condition of incommu-
pression of the crisis of participation to the man- nicability that exceeds a theatrical performance
ifestations of common sense. The loss of the of the absurd.
reassuring participation in socially shared inter-
pretative procedures leads to the inability to un- Attunement
derstand the meaning of the objects that occupy According to Minkowski’s (1927) definition,
one’s own cultural context, the schedules, the schizophrenia is a loss of vital contact with real-
sets of regulations and rules of behavior required ity, a loss of the ability to syntonize with one’s
by social situations; all this takes on a totally surroundings, to tune in with the flow of every-
different value for people suffering from autism, day life. Schutz (1964), in his essay “Making
compared with healthy people. Music Together” defines attunement as a pre-
But apart from the loss of the tacit and un- categorial and pre-linguistic relationship that
questionable evidences of meaning, the autistic picks up the essential structure of social inter-
condition may also lead to the expansion of the course and interpersonal relations and he em-
horizon of meaning (Schwartz, Wiggins, and phasizes its pre-thematic, spontaneous and intui-
Spitzer 1997), this too being a phenomenon that tive attributes. This anti-predicative consciousness
is completely absent in normal psychic condi- of the Other is a primordial datum of life, present

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in the spontaneity of contact with other individ- phenomenon is “the phenomenal basis of syn-
uals and not ascribable to a knowledgeable re- cretic sociability, of pathic identification or, in a
construction of the other person’s experience. word, of intersubjectivity” (Dillon 1988, 122).
In a face-to-face situation the two interlocu- Intercorporeality is never fully evident, but it
tors perceive one another and share a well-de- is the bearing support of all interaction connect-
fined space–time section. Schutz maintains that ed with behavior, already active and present ahead
the inner time (Bergson’s durée) is the means that of any explicit communication. The perceptive
carries the flux, which consents the harmonizing bond between me and another person is based
of a reciprocal relationship, that is, attunement. on my possibility to identify with the other per-
In any case, attunement is not an act of theoreti- son’s body by means of a primary perceptive tie.
cal cognition, but has the characteristics of an In this optics, therefore, the term sense, as
intuition, of an instinct as Bergson (1907) in- used in the expression “common sense,” must be
tended the term, charged with a strong tone of interpreted literally: sense as perception, sensa-
emotion (Scheler 1973; Stern 1985–2000): at- tion, impression. And from here stems a further,
tunement moves in the direction of the Other’s fundamental meaning of the notion of common
emotions. sense seen as the embodiment of self-awareness.
It is impossible to describe the phenomenon of It is the embodied profile of common sense (cp.
attunement separately from that of corporeality. next paragraph), the hyphen between interior
The lived-body is the instrument by which the and exterior, between subjective body and inter-
field of experience is organized, and interaction subjectivity.
with the world and reciprocal syntonization with In incipient schizophrenia, a variety of distor-
other individuals takes place (Merleau-Ponty 1945). tions of the bodily experiential modes may be
The notion of chair (lived-body, Leib), as op- observed, as if Husserl’s (1950) distinction be-
posed to that of object-body (Körper), implies tween living-body (Leib) and anatomical body
the intention of placing the lived-body at the (Körper) were suddenly to spring to life. In schizo-
center of the problem of intersubjectivity. phrenic depersonalization the sensation of loss
The body is not only our anchor to the world, of ease of one’s actions is felt, and with it the
it is the means by which to own the world, impression of changes to the morphology of one’s
insomuch as it structures and organizes the chanc- own body, leading to phenomena of obsessive
es of participating in the field of experience. The self-observation (the mirror sign) and, more in
perceptive organization of the field of experience general, to a progressive sense of distance from
is possible because the active and receptive po- one’s own body.
tentials of our own body are constantly project- The phenomenon known as morbid objectifi-
ed into it (Sheets-Johnstone 1999)—a web that cation describes the morbid insistence on thing-
Merleau-Ponty has called corporeal schema— ness (Cutting 1999) attributed to the body, and
quietly at work whatever we do. Intersubjectivi- the progressive dismissal of the emotional quali-
ty and intercorporeality: a communion of flesh ties of the living being: the body is felt as if it
and not a relationship between separate persons. were a prosthesis.
The term intercorporeality is intended to make In synthesis, schizophrenic autism moves in a
the meaning of the tacit cogito notion clearer condition of social drifting that derives from the
and more explicit. It refers to the originary and incapacity to enter into emotional attunement
indomitable experience of the body pertained to with others and recognizes as primum movens a
itself and to the other person on which the phe- different quality of bodily performance. The at-
nomenon of intersubjectivity is based. Intercor- tunement disorder has its roots in the nonconsti-
poreality means the transfer of the corporeal tution of that common aisthesia, that common
schema, the primary (that is reflected but not way of organizing experience in its primary per-
reflexive) bond of perception by which we recog- ceptive moment, linked to the body’s basic coen-
nize others as being similar to ourselves. This esthesic experience (Stanghellini 2004).

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Selfhood acterizes as “pure impressionability, that radical-

The Self Era, referred to the field of phenome- ly immanent self-affection which is nothing but
nological psychopathology, had had a return with our flesh (chair)” (Henry 2000).
Laing (1959) who, without actually giving it a As with the concept of ‘attunement’, it is near-
conceptual collocation, described the wobbly ly impossible to approach the notion of ‘ipseity’
foundations of Selfhood in the schizophrenic con- separately from that of ‘corporeality’. One’s own
dition and its consequent splitting up. The basic body, or better embodiment—the fundamental
constitutional fragility of the schizoid person proprioceptive schema - is the essence of ipseity:
brings about a condition of ontological insecuri- the background of all experience, the null point
ty, characterized by a feeling of vagueness, foggi- of one’s own presence to oneself and to the world.
ness, deprived of the reassuring certainty of what Ipseity is yet another facet of the phenomenon
is one’s own, the agonizing feeling of imploding of common sense, representing sensory and pri-
internally, of being unable to cope with social mary self-awareness, as opposed to noetic and
confrontation as a face-to-face relationship with reflexive self-awareness. The notion of ipseity,
another person. Existence is oppressed by the intended as sensory self-awareness, goes back to
fear of being swept away by other people and the oldest and original conception of common
losing oneself in the environment. In fact, the sense - the koiné aisthesis. Anticipated by Aristo-
individual Self splits into a false Self, an exterior tle, the koiné aisthesis represents the foundation
inauthentic construction, and an interior inade- of both self- and social-awareness (Stanghellini
quate Self, detached from shared reality and 2004).
crouching in a non-reistic world of its own. The schizophrenic ipseity abnormality betrays
More recently (e.g., Parnas and Sass 2001) the a crack, a slot that widens as with a wedge, in the
schizophrenic self-experience problem has been fundamental experience of oneself, annihilating
attributed to a constitutional deviation of ipseity its spontaneity and interrupting its flow. And so
that, according to the philosopher M. Henry the clinically evident disorders appear, character-
(1963), is the primordial matrix of subjectivity. istic and medically specific, vividly present in the
The French philosopher recognizes the basic prodromal phases (Parnas and Sass 2001), such
nucleus of Selfhood in ipseity. From the angle of as, for example, the distortion of first-person
Henry’s concept of ‘ipseity’, Selfhood is not a perspective (it is not me who is perceiving that
cognitive representation of oneself, or the out- object, but something in me that perceives it) or
come of an introspective experience. Rather, it is phenomena of ontological insecurity (as, for ex-
a pre-reflexive, pre-thematic, pre-cognitive phe- ample, lack of Self/Other demarcation).
nomenon. Henry’s characterizes ipseity as the The final result is the picture of schizophrenic
primordial contact with oneself and he uses the depersonalization that appears as an experience
term “self-affection” to express the foundation of increasing distance (Sass 1992) between sub-
of Selfhood, in which who feels and who is felt jectivity and body experience, between subjectiv-
are a one and only thing. ity and flux of awareness, up to the overflowing
Ipseity is a pre-reflexive phenomenon: a kind of inner experience and the loss of perception of
of immediate acquaintance with oneself, radical- one’s boundaries.
ly different from a kind of noetic experience, In the perspective disclosed by the concept of
“because there is no gap in the ipseity of subjec- ipseity, schizophrenic autism reflects the funda-
tivity [ . . . ], not the tiniest space into which a gaze mental constitutional fragility of Selfhood, that
can enter” (Henry 1990). It is pre-thematic since is its fundamental incompleteness which results
it is not an act of theoretical cognition: it usually in problematic relations, meetings and confron-
remains under the threshold of conscious aware- tations with the Other. Detachment from the
ness, and normally is not explicitly perceived. It social world appears to derive from the lack of
is a pre-cognitive phenomenon since it is based this fundamental structure, of this ontological
on affectivity: a kind of pathos that Henry char- setting, necessary and indeed crucial to be a Self

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and thus to take part in the Self/Other-from-self Antagonomia can be conceptualized as the delib-
dialectic of social relations (Ballerini submitted; erate attempt to disengage from all the sources of
Stanghellini 2001). In other words, the constitu- taken for grantedness, unwitting typification and
tive defect of the phenomenal Self is reflected in inauthenticity. It also implies the need for dis-
its complementary dimension, the Self’s social tinctiveness, and fight for differentiation and
dimension. uniqueness. We could also speak of idionomia;
idionomia and antagonomia together character-
Value System ize the antagonistic attitude on which the idio-
The value system is a set of regulations and syncratic system of values and beliefs of schizo-
trends inescapably bound to the social dimen- phrenic persons is based.
sion of actions, because whatsoever project in The phenomenon of antagonomia describes
life can only be carried out in the world and the attitude of schizophrenic patients toward the
within the domain of relationships with other social world; schizophrenic patients are skeptical
human beings. toward conventional knowledge and socially
The value system is a cognitive requirement, it shared values; they conceive the social world as a
is the “philosophy of life” that can be made game of mechanic relationships based on imper-
explicit in propositional terms, followed as a sonal algorithms; they also display a general dis-
guideline of one’s actions and, more generally, of trust towards attunement. In a nutshell, they
the plan for life that each of us strives to carry construct the social world not as first-person “I–
out (Weber 1922). At the same time it is an you” encounters, but as ruled by third-person
emotional requirement (Scheler 1966), inasmuch “It–It” relationships. Conventional knowledge,
as rooted in the sphere of rules trends, on the personal (emphatic) relationships, and attune-
whole it implicitly regards what, for each of us, ment are seen as dangerous sources of loss of
is more or less desirable. individuation.
Does there exist a configuration of values and Schizophrenic autism sets itself as the landing
thus a fundamental personal disposition—an place of a laterality or an ethic and epistemic
ethos typically tended toward schizophrenia? eccentricity adopted by the sick person with re-
Even if we are not able to refer to any typolo- spect to common sense and the social world that
gy empirically founded on quantitative studies, stems from it. It can be a condition that weighs
we can propose an eidetic typology, founded, on the person like a blow of fate and against
that is, on meaning organizers derived from qual- which he or she may even oppose a strenuous
itative investigations. resistance, but it can also be a choice, that is, a
The eidos that characterizes the deviation from desire to follow unexplored pathways, to leave
common sense of the value system of schizo- the beaten track. This choice can prove to be a
phrenic persons is a deliberate epistemological way of no return, or no less than a descent into
and ethical attitude consisting in the disdainful hell.
refusal of taken for grantedness (of conventional
meanings, values, and beliefs) and of attune- An Integrative Hypothesis
ment. We may call this phenomenon antagono-
To attempt to establish a pathogenetic priori-
mia (Stanghellini 2000). Typical self-reports are
ty among the four phenomena described as es-
the following:
sential components of schizophrenic autism may
What I hate most is to be persuaded by the others. be a futile or indeed childish exercise. To make
I do not want to get caught in their way of thinking. an example: The fact that in schizophrenia there
My refusal of common sense is stronger than my seems to be some kind of alienation of oneself
life instinct.
from oneself (and from the world) is in itself
The others know the rules, I need to study them. I
feel better than the others and worse than the others grounds for supposing that there is some funda-
at the same time, since I do not have the rules and I do mental, primitive, nonrelational auto-awareness
not depend on them. that is primarily disrupted? Often the arguments

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on the subject of which phenomenon comes first of the other and, altogether, to the intercorporeal
turn out to be like the quarrels of children on a bridge toward the other person. But, looking at
merry-go-round, each of whom maintains it is it from the opposite angle—that is, from the
his or her horse that is ahead of the others. What interpersonal dimension of the ontogenesis of
we do need is an integrative hypothesis by which consciousness—a disorder in early relationships
to detect, in the first place, the common semantic can heavily damage the maturing process of full
denominator—the unit of meaning—of the phe- corporeal self-awareness.
nomena examined (Figure 1). Now, the element that sums up all the dimen-
The truth remains this, even if some scholars sions of autistic existence here described—inscribes
have convincingly underlined the decisive role of them, that is, within the same semantic–interpre-
attunement in bringing about the phenomenon tative circle—appears to be the phenomenon of
of attachment during the primary phases of the disembodiment. The disembodiment of the Self,
mother–child relationship (Hobson 1994; Stern of interpersonal relationships, and also of the
1985–2000), to the point of becoming the main- cognitive-categorial schema with respect to its
stay of the capability of setting up significant extensional references situated in the social world,
interpersonal relationships. The possibility of re- and lastly the assertion of goodness (in the ethi-
ciprocal syntonization—that is, the entry into cal sense), and of the need (in the epistemic
contact and the mutual harmonization of the sense) for principles and morals far detached
respective mental activities—is the constitutional from the warmth of the flesh (their own and
field of common sense, in fact, in all likelihood, other people’s), and of emotions, all lead back to
the primum movens toward the establishment of an organization of meaning in which the autistic
a common register of meanings. The condition person lives and behaves like a soulless body or a
of idionomia—the articulation of the schizophren- disembodied spirit.
ic world in elusive and paradoxical semantics The ipseity crisis is the clearest expression of
(and logic), far beyond the boundaries of com- the shape autistic life assumes as a soulless body,
mon sense—may be essentially seen as the conse- deprived, that is, of the possibility of living per-
quence of an abnormality of this basic property sonal experiences—perceptions, thoughts, emo-
of the mind (Ballerini submitted). In this sense, tions—as its own, and also as a disembodied spirit,
therefore, the disorder of social cognition ap- that is as a sort of abstract entity which contem-
pears as secondary with respect to the disorder plates its own existence from outside—a third-
of emotional attunement. But what is even more person perspective view, or a view from nowhere.
surprising and characterizing is the replacement, The attunement crisis conveys this third-per-
in the social relations of schizophrenic persons, son perspective to the interpersonal world as
of a first-person perspective based on prereflec- well. This loses its characteristic as a network of
tive attunement, with a third-person perspective relationships among bodies moved by emotions
based instead on the heuristic application of al- and turns into a cool, incomprehensible game,
gorithms and abstract rules, coolly deduced from from which the autistic person feels excluded,
a quasi-ethological observation of social life. and whose meaning is sought through the dis-
Much more complex are the relations between covery of abstract algorithms, the elaboration of
the disorders of ipseity and of intersubjectivity– impersonal rules.
intercorporeality, in which we can recognize a Also the cognitive-categorical sphere, that al-
circular relationship. In a certain sense the (miss- ready in itself inclines to abstraction, becomes,
ing or defective) structuring of the ipseity, partic- so to say, bodiless: meanings, that is words, es-
ularly through the phenomena of somatopsychic cape the situation to which they are referred and
depersonalization (bodily perception disorders) the meaning they take on according to the con-
and autopsychic depersonalization (detachment text in which they are used. They too become
from one’s own emotions and thoughts), can disembodied and desituated, and acquire an ex-
become an obstacle to the empathetic perception istence of their own. They themselves become

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 STANGHELLINI AND BALLERINI / AUTISM: DISEMBODIED EXPERIENCE ■ 267

FIGURE 1. MEANING ORGANIZERS OF AUTISM: THE LINKS.

Cognition < Attunement

<
<

<
<

<
Selfhood Attitude

objects, that is entities undistinguishable from ———. 1971. Der Verlust der natuerlichen Selbstver-
“real” objects (these, too, disembodied and thus staendlichkeit. Stuttgart: Enke.
more similar to concepts and representations than Bleuler, E. 1911. Dementia Praecox oder Gruppe der
Schizophrenien. Leipzig: Deuticke.
to material objects). Words are no longer used to
Cutting, J. 1999. Morbid objectivization in psychopa-
share a world, but to create an alternative one. thology. Acta Psychiatrica Scandinavica 99, suppl.
Therefore, words and things can exchange plac- 395:30–3.
es, they become interchangeable: paradigmati- Dillon, M. C. 1988. Merleau-Ponty’s ontology. Evan-
cally, metaphors become flesh-and-blood things, ston, IL: Northwestern University Press.
the catachresis (concrete expression) of meta- Gadamer, H. G. 1960. Warheit und Methode. Tuebin-
phors flings open the door of that world, which gen: Mohr.
Garfinkel, H. 1967. Studies in ethnomethodology.
we call delusional.
New York: Englewood Cliffs.
Finally, all this is manifest (sometimes), even Henry, M. 1963. L’essence de la manifestation. Paris:
at a propositional level, articulated according to P.U.F.
a system of values, especially in those people Henry, M. 1990. Phénoménologie materielle. Paris:
who have not yet developed a patent form of P.U.F.
schizophrenia. The world of these people’s val- Henry, M. 2000. Incarnation: Une philosophie de la
ues above all reflects an effort of disengagement chair. Paris: Seuil.
from all sorts of embodiment and situatedness. Hobson, R. P. 1994. Understanding persons: The role
of affect. Ed. Baron-Cohen, S., H. Tager-Flush-
This disembodiment of the Self, of interper-
berg, and D. J. Cohen. Understanding other minds:
sonal relationships, and of words, which rises to Perspectives from autism (pp. 204–27). Oxford:
a quasi-philosophical system in the sphere of Oxford University Press.
values, for us represents the theme of autistic Husserl, E. 1950. Cartesianische Meditationen und
existence. Pariser Vortrage. Den Haag: M. Nijnoff.
———. 1959. Der Krisis der Europaeischen Wissen-
References schaften und die Transzendentale Phenomenolo-
gie. Den Haag: M. Nijnoff.
American Psychiatric Association. 2000. Diagnostic
Kretschmer, E. 1921–1961. Korperbau und Charak-
and statistical manual, IV, text revision. Washing-
ter Berlin: Springer.
ton DC: American Psychiatric Association.
Laing, R. D. 1959. The divided self. London: Tavis-
Ballerini, M. submitted. Schizofrenia, Autismo, Dis-
tock.
Socialità/Idionomia.
Mead, G. H. 1934. Mind, self and society. Chicago:
Berger, P. L., and T. Luckmann. 1966. The social
University of Chicago Press.
construction of reality. Doubleday, New York.
Merleau-Ponty, M. 1945. Phénoménologie de la per-
Bergson, H. 1907. Evolution creatrice. Paris: P.U.F.
ception. Paris: Gallimard.
Binswanger, L. 1956. Drei Formen Missglueckten
Minkowski, E. 1927. La schizophrenie. Paris: Desclée
Daseins. Tuebingen: Max Niemeyer.
de Brouwer.
Blankenburg, W. 1969. Ansaetze zu einer Psycho-
Mundt, C. 1991. Constituting reality: Its decline and
pathologie des ‘common sense.’ Confinia Psychiat-
repair in the long-term course of schizophrenic
rica 12:144–63.

11.3ballerini. 267 10/21/04, 3:53 PM

 268 ■ PPP / VOL. 11, NO. 3 / SEPTEMBER 2004

psychoses: the intentionality model. Ed. Marneros, reappraisal from new perspectives. Journal of Ner-
A., A. C. Andreasen, and M. T. Tsuang. Negative vous and Mental Diseases 185, no. 3:176–87.
versus positive schizophrenia (pp. 96–108). Berlin/ Stanghellini, G. 2004. Disembodied spirits and deani-
Heidelberg: Springer-Verlag. mated bodies. The psychopathology of common
Parnas, J., and P. Bovet . 1991. Autism in schizophre- sense. Oxford: Oxford University Press.
nia revisited. Comprehensive Psychiatry 32:1–15. ———. 2000. Vulnerability to schizophrenia and lack
Parnas, J., and L. Sass. 2001. Self, solipsism and of common sense. Schizophrenia Bullettin 26, no.
schizophrenic delusions. Philosophy, Psychiatry, & 4:775–87.
Psychology 8, no. 2/3:101–20. ———. 2001. Psychopathology of Common Sense.
Sass, L. A. 1992. Madness and modernism: Insanity Philosophy, Psychiatry, & Psychology 8, no. 2/
in the light of modern art, literature, and thought. 3:201–18.
Cambridge MA: Harvard University Press. Stanghellini, G., and M. Ballerini. 2002. Dissociality:
Scheler, M. 1966. Der Formalismus in der Ethik und The phenomenological approach to social dysfunc-
die Materiale Ethik. Bern/Munchen: Francke. tion. World Psychiatry 1, no. 2:102–6.
———. 1973. Wesen und Formen der Sympathie. Stern, D. N. 1985–2000. The interpersonal world of
Bern/Munchen: Francke. the infant. New York: Basic Books.
Schutz, A. 1962a. Symbol, reality and society. Ed. Stroemgren, E. 1969. Uses and abuses of concepts in
Natanson, M. Collected papers (volume 1) (pp. psychiatry. American Journal of Psychiatry 126,
287–356). Den Haag: M. Nijhoff. no. 6:45–56.
———. 1962b. Common sense and scientific inter- Tatossian, A. 1984. Phénoménologie de la schizophrénie.
pretation of human action. Ed. Natanson, M. Col- Schweiz Archiven fuer Neulogie, Neupsychiatie und
lected papers (volume 1) (pp. 3–47). Den Haag: Psychiatrie 135:9–15.
Martinus Nijhoff. Weber, M. 1922. Wirtschaft und Gesellschaft. Tue-
———. 1964. Making music together. A study on bingen: Mohr.
social relationships. Ed. Broadersen, A. Collected World Health Organization. 1992. The ICD-10 clas-
papers (volume 2) (pp. 159–178). Den Haag: Mar- sification of mental and behavioural disorders: Clin-
tinus Nijhoff. ical descriptions and diagnostic guidelines. Gene-
———. 1970. Reflection on the problem of relevance. va: WHO.
New Haven, CT: Yale University Press. Wyrsch, J. 1949. Klinik der schizophrenie. Ed. Gruh-
Schwartz, M. A., O. P. Wiggins, and M. Spitzer 1997. le, H. V., R. Jung, R. Mayer-Gross, and M. Muller.
Psychotic experience and disordered thinking: A Psichiatrie der Gegenwart. Berlin: Springer.

11.3ballerini. 268 10/21/04, 3:53 PM