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ABSTRACT: This paper, on the psychopathology and phenomenology of schizophrenia, presents a selective summary of the work of the French psychiatrist, Eugene Minkowski (1985-1972), one of the first psychiatrists of an explicitly phenomenological persuasion. Minkowki believed that the phenomenological essence of schizophrenia (what he called the "trouble generateur") consists in a loss of "vital contact with reality" (VCR) and manifests itself as autism. Loss of vital contact with reality signifies a morbid change in the temporo-spatial structure of experiencing, particularly in the diminishment and modification of temporaldynamic aspects and a corresponding predominance of spatial-static factors. The patient tries to compensate for this primary morbid process through a variety of affective-cognitive preoccupations (rich autism) or sterile intellectuoid attitudes (autisme pauvre). Autism signifies a morbidly modified existential pattern that affects the domains of experience and expression as well as action. Minkowski's psychopathological analyses are illustrated by brief clinical vignettes of his patients.
KEYWORDS: autism, loss of vital contact, consciousness, duree, structural analysis, phenomenological compensation.
INTRODUCTION
IN CONTINENTAL EuROPE, Eugene Minkowski is considered to be one of the most original psychopathologists of the twentieth century.1 He is renowned for a novel view of schizophrenia as an altered existential pattern and for a radical conceptualization of psychiatric phenomenology as a method of "penetrating" to the structure of experiencing. His views differ substantially from the perspectives held by Bleuler (1911), Kraepelin (1899), and Jaspers (1923). Together with a Swiss psychiatrist, Ludwig Binswanger (1963), he may be considered to be the first psychiatrist of an explicitly phenomenological persuasion. Laing (1963, 1959) described Minkowski as having made "the first serious attempt in psychiatry to reconstruct the other person's lived experience." Minkowski's views on schizophrenia continue to stimulate clinical and theoretical interest (Tatossian 1979; Parnas and Bovet 1991; Sass 1992; Cutting 1985, 1997), and his thoughts on method remain relevant. It is the purpose of this article to offer a brief but systematic introduction to Minkowski's ideas for the Anglophone reader.
The task of summarizing Minkowski's thought has not been entirely unproblematic. His style is often high-flown, metaphorical, and literary in a way that is alien to contemporary readers of professional journals. A more substantial difficulty is the fact that Minkowski can be rather unsystematic and vague; he is certainly...