[Clinical study of prejudicing autochthonous speech act (thought)--acceleration of the activity in the remission process of schizophrenia].
Schizophrenics occasionally experience guilty feeling at having insulted someone such as having said "You fool" or "Die" to a new acquaintance. They also experience guilty feeling from autochthonous thought, a feeling of having prejudiced his neighbour. This latter autochthonous thought is considered to be closely related with the former prejudicing speech act. The author would provisionally call these phenomenons of prejudice, prejudicing autochthonous speech act (or prejudicing autochthonous thought), particularly in the case in which the object of prejudice is an intimate real other, or a co-presenting other. Based on his own nine cases, the author has first described the clinical characteristics of this symptom, and then developed psychopathological considerations to draw a attention to the therapeutic importance of this symptom. On the symptomatological ground, the prejudicing autochthonous speech act (thought) belongs to psychomotor verbal hallucinations (J. Séglas), more precisely to the soliloquy type of this hallucination. On the clinical ground, this symptom is likely to follow auditory hallucination caused by an acute state or that of recovery period from this state. Furthermore, it is not infrequent that general improvement as well as remission follow the appearance of this symptom. This symptomatological change of the center of gravity, that is, the gradual transition from auditory hallucination to prejudicing autochthonous speech act (thought) is considered to correspond to a change of the patient's position in relation to others. This position, once experienced passively, is now experienced actively. In other words, the patient, coming out of an acute psychotic state and opening to an intersubjective world, is confronted with a high tension relationship with others. The prejudicing autochthonous speech act (thought) appears in this situation, to restore the patient's own subjectivity in coping with the pressure of real others. In this case, this phenomenon is considered to have a selfhealing effect. Prejudicing autochthonous speech act (thought), presents not only a certain disappearance process of auditory hallucinations, but also a kind of acceleration of the patient's activity in the preremission period which leads to a remission. Prejudicing autochthonous speech act (thought) should be therefore considered in the therapy of schizophrenics.
Kato
S
S
Department of Psychiatry, Jichi Medical School.
D000293:Adolescent; D000328:Adult; D005260:Female; D006212:Hallucinations; D006801:Humans; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D012075:Remission, Spontaneous; D012565:Schizophrenic Psychology; D013060:Speech; D013850:Thinking