The Issue of Intersubjectivity in Working with Schizophrenia: a Single Case Exploration

1. The Issue of Intersubjectivity in Working with Schizophrenia: a Single Case Exploration LEUNG Sze-ming, Samuel Instructor/PhD candidate Department of Applied Social Sciences 17 Dec 2009

2. Abstract growing concern about the issue of intersubjectivity in schizophrenia that those people with this illness used to have difficulties in interpersonal readiness. concern not only raised by philosophers, phenomenologist and psychoanalysts in describing the dysfunctional schizophrenic experience as a phenomenon, but also extend to the explanation of it as well as the clinical implication, if any, in working with those people with schizophrenia. By means of analysing the interview transcripts between the researcher and a adult schizophrenic case, the issue of intersubjectivity will be discussed. Clinical implication in working with people with schizophrenia will be addressed also.

3. Let�s start with a Case Client A, male in 40s, divorced, suffered from schizophrenia in early 30s, now living in a psychiatric halfway house. He is able to attend a part-time post in a supported employment project, with reasonable performance However, he is silent, passive, even withdrawal in normal interaction, in which encouragement is needed. He will appear in most house programs, but leaving himself sitting at the corner only. Some residual delusions about his family, marriage and wife would be expressed, but not frequently. Most often, he is claim and stable, reportedly to be �mentally stable�

4. Case�s transcript (Selection) �no friendship is needed� �I did not belong here� �I have nothing to say� �no problem� �feel really good� �I sometimes even don�t know who am I, and what will I going to be� �I don�t know why they (family) did that to me�.even killing me�..my father is harmful to me� �I won�t come back after discharge, and won�t let them (residents) to visit me either.�

5. What is intersubjectivity Generally known as Husserl�s cardinal principle of the philosophical method in Phenomenology Intersubjectivity is inseparable from the concept of experience Applicable in determining self�s relation to others, and between self�s experience of others as subjects of experiences = subject�s conscious experience of others

6. What is intersubjectivity (2) This approach which focus on investigating self�s conscious relation to others (Husserlian) was not uncommon in psychiatric literature and psychoanalytic literature It was continuously noted by elaborated by Heidegger, Binswanger, Minowski etc. Object of experience can never be decisively separated from the subject who experiences it.

7. Intersubjectivity and Schizophrenia In contemporary phenomenological research in the mental health field, Schizophrenia is always being one of the most popular illness that has been focused on. Intersubjectivity research on Schizophrenia used to focus on disturbances occurred in human relationship, in which relational deficits are obviously.

8. Research findings in schizophrenia interpersonal relationship: Schizophrenia, subjectivity and self Major findings [1], in schizophrenia, a sense of self is missing, results in disturbances in agency, selfhood and first-person-ownership (probably the root of hallucination, delusion, idea of reference) Major findings [2], in schizophrenia, there is a fear of losing one�s self, one�s identity in the interpersonal relationship (probably the root of withdrawal, passivity)

9. Subjectivity and intersubjectivity in psychotherapy Discussed by Stanghellini & Lysake (2007), their work moved forward from pure subjectivity to intersubjectivity first-person perspective "I-You� or second-person perspective Third-person perspective The second person experience, intersubjectivity level, is based in the implicit attunement between oneself and the other (Parnas & Bovet, 1991). In the �I-You� perspective, it is where intersubjectivity issues raised. Schizophrenia, however, sometimes used to operate like a third person, thus cannot enjoy personal involvement, i.e. intersubjectivity is missing.

10. Case�s transcript revisit