title: In recovery from schizophrenia: regaining social cover - a phenomenological investigation.
abstract: We offer here a framework for the understanding of being in recovery from schizophrenia as an interpersonal process. We draw upon in-depth phenomenological descriptions of the fundamental changes taking place in an individual's mental life when they are suffering from schizophrenia. There is a loss of commonsensical habituality and interpersonal capabilities, usually most prominently expressed as an impaired intersubjective resonance. People with schizophrenia cannot as easily automatically and coherently display their own emotion via their facial expressions or perceive those of others, as do 'normal' people. This implies that interpersonal resonance between interacting individuals is not automatic, as is often taken for granted. The need to actively rebuild interpersonal resonance also holds true for the interacting 'normal' person, but would be an unfamiliar and unexpected task. These difficulties in empathizing provoke a mismatch in interpersonal resonance, often leading to the intuition that the person having schizophrenia lacks (explicit) self-awareness. We conclude that there is a mismatch in the form and scope of the social cover extended to the social role opportunities available in trans-Atlantic cultural settings for people with schizophrenia. Typically, these social roles imply that people with schizophrenia are unaware of themselves; however, while they often lack insight or may not consider their symptoms as signs of a mental disorder, they are usually not 'confused' or 'distracted' in the sense of no longer being aware of themselves. We discuss various options for adequate social cover achievable for people with schizophrenia, demonstrating their impact on the recovery process.
authors.affiliation: Psychiatric University Hospital Charité at St. Hedwig Hospital, Charité Universitätsmedizin, Berlin, Germany. jann.schlimme@charite.de
authors.forename: Jann E
authors.initials: JE
authors.lastname: Schlimme
authors.forename: Michael A
authors.initials: MA
authors.lastname: Schwartz
mesh_terms: D001364:Awareness; D004645:Empathy; D006801:Humans; D007398:Interpersonal Relations; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012649:Self Concept