Medicine: Psychiatry:

 

The Passion of Will in Schizophrenia:

Towards a Philosophy of Mental Disorders

 

by Bernhard Mitterauer, MD

Prof.em. (University of Salzburg)

Volitronics-Institute for Basic Research

Wals, Austria

 

Link for Citation Purposes: https://bwwsociety.org/journal/current/2020/jul-aug/the-passion-of-will-in-schizophrenia.htm

 

Abstract

A new psycho-bio-philosophical model of schizophrenia, characterized as a passion of will, is proposed. This model is based on five elementary volitive processes. These are the primordial volition to act; the volition to self-instrumentalize; the volition to program intention; the volition to generate realities; and the volition to permanent existence. Imbalances in information processing in tripartite synapses and their network in the brain may be responsible for dysfunctions of self-instrumentalization. In addition, the volition to program intentions and the volition to generate realities are affected in delusions and hallucinations, but still work. As shown in tripartite synapses of the brain, a gap between sensory information processing in the neuronal networks and the ‘inner’ glial networks causes the inability to distinguish between the self and the other. This loss of self-boundaries underlies the main symptoms of schizophrenia such as delusions and hallucinations. Furthermore, it is suggested that the volition to permanent existence works ‘deep in the soul’ of the patients experienced as the eternal Now. Because of the loss of self boundaries the destiny for communication becomes staged as pseudo communication. Since the destiny for communication is unfeasible in the environment, this state is characterized as dysintentionality. Together, the model proposed allows to delve deeper in the reality experience and communication pathology of patients suffering from schizophrenia.

 

1.  Introduction

 

Towards a philosophy of mental disorder (Mitterauer 2019; 2020) I propose a psycho-bio-philosophical model of schizophrenia interpreted as a disorder of volition. Schizophrenia is a chronic progressive psycho-biological disorder. The typical symptoms of schizophrenia are delusions and hallucinations (positive symptoms) and thought disorder, affective flattening and catatonia (negative symptoms) (American Psychiatric Association 2013).These symptoms are basically caused by the loss of boundaries between the self and others making the patient unable to distinguish between his (her) own thoughts and perceptions of the environment (Hales et al.,1999). It is of significance that already Kraepelin (1919) and Bleuler (1950) highlighted the central role of avolition in the phenomenology and the course of the illness. Presently, it is suggested that avolition underlies the negative symptoms of schizophrenia associated with dysfunctions in various brain areas. According to Frith “passivity experiences involve a failure to recognize who is the agent of an action “leading to inappropriate actions of schizophrenics” in the social context.” Basically, avolition directly influences neurocognitive dysfunction of patients with schizophrenia (Frith, 2006).

 

To the best of my knowledge, Kant was the first in Western philosophy who set out an anthropological account of mental disorders. Though Kant’s Taxonomy of the mind considers the cognitive faculty and the faculties of feeling and desire, the phenomenology of “mental derangement” that may correspond to schizophrenia represents disorders of the faculty of cognition, but not of desire (Kant, 1980; Frierson, 2009). In our days, various theories, mostly focusing on delusions and hallucinations, attempt to interpret schizophrenia as a disorder of cognition (for review see Kiran and Chaudhury, 2009). Importantly, Graham’s seminal work “the disordered mind” elaborated the connection between rationality and intentionality constrained by rationality (Graham, 2010). In the scope of the present investigation it is of special interest that based on experiments on decision processes schizophrenia is described as a disorder of volition (Prinz et al, 2006). Though these models support my hypothesis that schizophrenia is a disorder of volition, avolition as such cannot explain the reality experience of schizophrenia on the existential level, since a comprehensive theory of volition is lacking. Here, I propose a psycho-bio-philosophical model of schizophrenia in the sense of a passion of will.

 

2.  Architecture of volitive processes

 

Basically, volition is a conscious decision process (Jeannerod, 2006). However, recent investigations of the processes of goal pursuit discovered that these processes also work without conscious awareness (Custers and Aarts, 2010). I introduced an architecture of five elementary volitive processes conceptualized as the primordial volition to act; the volition to self instrumentalize; the volition to program intentions; the volition to generate realities; and volition to permanent existence (Mitterauer, 2019). Though these volitive processes operate mostly on the unconscious level their interactions may generate conscious decisions.

 

2.1 The primordial volition to act

 

The primordial volition to act commands and controls all volitive processes. Augustinus was the first in the history of Western philosophy who described the primordial will as absolutely free from external and internal constraints and especially independent on reason (Augustinus, 2001). As a metaphysical conception the primordial will is driven by the movements of the soul and can therefore not be identified in the brain. Although many philosophers deal with the problem of free will (Gehlen, 1965), an explicit treatment of the primordial will represents the core of the philosophy of the German philosopher Schoppenhauer (1977). This doctrine says that the primordial will is a-rational, independent of space, time, and purposeless. At the human level reason is a secondary product of will. In this context, the position of Kant is of special interest. Though Kant is the philosopher of Pure Reason, in the Categorical Imperative he insists on the primacy of will and the absolute sovereignty of free decision (Kant, 1914; Günther, 1976).

 

Crucially, the primordial volition to act is not a pure philosophical conception, but can be formally described in quantum mechanics (Baer, 2010; 2019). Action cycles function in permanent movement. This permanent cyclic movement I interpret as the action of primordial volition. “The 1st-person’s will and desire is built into properties of action loops. It is the fundamental desire of all activity loops to increase the amount of an action it experiences in an equilibrium form that minimizes unbalanced forces” (Baer, 2019). Note, these action loops do primarily not generate cognitive processes, but are the conditio sine qua non for further cognitive operations. Most importantly, if we consider the philosophy of will according to Augustinus and Schopenhauer, we are faced with two opposite world views. Whereas Augustinus’ conception of volition represents a desire to devine permanence, for Schopenhauer the will is inherently selfish and insatiable leading to dissatisfaction and suffering. Therefore, the path to existential salvation is escaping from the will’s tyranny toward Nirvana.

 

For understanding the role of volition in the reality experience of patients with mental disorders or schizophrenia, it is decisive if the model proposed is based on a “destructive”  or “constructive” concept of volition. My interpretation of schizophrenia as a passion of will is based on a psycho-biological model of constructive volition.

 

 

2.1.1 The act of self-reference

 

Essentially, unlike the design of machines with special structures and functions, biological systems develop spontaneously and organize themselves (Kugler et al., 1980). This circularity must maintain a living system to retain its identity through the dynamics of interaction (Maturana, 1970). However, this holistic act of self-reference generated in the brain is a “mysterious function” (Günther, 1971) and is the fine line between experimental brain research and brain philosophy. I suggest that self-reference operates on two elementary mechanisms in the brain. On the one hand it represents a holistic, all integrating function. On the other hand, the act of self-reference must combine discontinuities or disconnections for the generation of action domains or realities. From a psychological point of view self-reference can be characterized as the elementary operation of narcissism (Mitterauer, 2009) (see section 2.5).

 

2.2 The volition to self-instrumentalize

 

Principally, for the generation of action effects or products the volition to act must self-instrumentalize with organs and mechanisms in the brain ensuring inner homeostasis and the generation of behavior for coping with the environment. Specifically, neuroembryology teaches us that motility precedes reactivity in the sense of a chronological primacy of the motor over the sensory. “It is well established that the basal plate, or motor part, of the spinal cord proliferates and differentiates long before the altar plate, or dorsal part, which receives sensory input. This observation has led some to speculate on the primacy of motor function, in a way that might provoke the cognitive neuroscientists” (Kelso and Tuller, 1984).The embryonic development enables the interpretation that the primordial volition to act starts its self-instrumentalization by movement. Typical mechanisms are spontaneous electrical activity in the fetal cortex (Moore et al., 2014) and spontaneous astrocytic Ca2+ oscillations (Parri and Crunelli, 2001).

 

Different from machines designed by humans to display special structures and functions in living systems or the human brain structures and functions evolve spontaneously “without a priori specification or representation of a new structure” (Kelso et al., 1981). In this context Leibniz differentiates between a natural organic body of an organism and a man-made machine: “Thus, the organic body of an organism is always a kind of divine machine or natural device, eternally superior, to all superficial devices. This is a machine in all its parts…However, natural machines, that is living bodies, stay machines forever, even in their tiniest parts” (Leibniz, 1956).

 

2.2.1 Volitive processes in tripartite synapses

 

Elementary structures of self-instrumentalization for information processing in the brain are synaptic glial-neuronal units, called tripartite synapses (Arague et al., 1999). A tripartite synapse consists of the presynapse and the postsynapse as the neuronal part, and the astrocyte as the glial part. Basically, the interactions between the astrocyte and the pre-postsynapse operate to maintain homeostasis in the synaptic system. Since the domain of the astrocyte controls synaptic information processing via astrocytic processes,  glial-neuronal units are best characterized as “astroglial cradles” (Verkhratsky and Nedergaard, 2014). Importantly, based on the “Conscious Action Theory” (Baer, 2010, 2019) feedforward-feedback loops can formally be described in tripartite synapses as action cycles (Mitterauer and Baer, 2020). Basically, feedforward-feedback mechanisms have been experimentally identified (Arague et al., 2014) and play a central role in my brain model (Mitterauer, 2013).

 

From an ontological point of view I suggested that the neuronal element (presynapse and postsynapse and their network) embodies objective subjectivity and the glial part subjective subjectivity (Mitterauer, 2013).

 

Figure 1 depicts a schematic diagram of feedforward-feedback loops between the glial network (GN) embodying subjective subjectivity (Ss) and the neuronal network (NN) embodying objective subjectivity (So) of the brain. First, the glial network feeds forward to the neuronal network (1). Further, the neuronal network feeds back to the glial network (2). The glial network feeds forward to the neuronal network again (3), and the neuronal network feeds back to the glial network closing the feedforward-feedback loop. Since feedforward controls the mental architecture (Basso and Bellardinelli, 2006), it represents an elementary volitive function. We experience objective subjectivity as subjects (Thou’s) in the environment and feel subjective subjectivity as Ego-consciousness on the behavioral level. With this in mind, I hypothesize that elementary volitive processes of self-instrumentalization operate on feedforward-feedback loops in glial-neuronal interactions.


Figure 1. Feedforward-feedback loops between the glial network (subjective subjectivity) and the neuronal network (objective subjectivity)

 

The glial network (GN) interpreted as subjective subjectivity (Ss) feeds forward to the neuronal network (NN) interpreted as objective subjectivity (So)(1). Sfeeds back to Ss (2), So feeds forward to So (3) and So feeds back to So(4) generating a loop.

 

2.3 Volition programming intentions

 

The definition of mind in terms of intentionality that originated in the Scholastic doctrine of intention (Aquinas, 1988) was revived by Brentano (1995) and has become a characteristic theory of German phenomenology (Husserl, 2005). Brentano gives us an excellent definition of intentionality: “intentional mental states are directed at things, such as flowers, fields, and fairies. Insofar as minds are capable of intentional mental states, intentionality is the mind being directed at things, which may or may not exist” (Brentano, 1995). In neuroscience experimental evidence indicates that special neuronal networks operate intentionally (Gallivan et al., 2011). In these networks feedback mechanisms are generated in different degrees of complexity (Koch, 2012) from recursion, reflective thinking, self-reflection to inter-subjective reflection (Mitterauer, 1998). These reflection processes work not only as cognitive operations, but generate also intentional programs. Morgan and Piccinini emphasize that cognitive Neuroscience can explain intentionality in terms of information and biological function (Morgan and Piccinini, 2018).

 

If we interpret the volition to act and the volition to self-instrumentalize as efficient causes, then the volition to program intentions and the volition to generate realities represent purposeful causes. Most importantly, Leibnitz stated that efficient causes can only be understood, if we also refer to purposeful causes (Leibniz, 1956). Since purposeful causes are generated by the will to program goals by cognitive processes, volition and cognition must interact in generating realities (Günther, 1976).

 

Considering the astroglial networks, interpreted as the subjective component of brain structures and functions, I formalized the mechanism of intentional programming in the astroglial networks (Mitterauer, 2007; 2013). Though several schools of thought have formulated the concept of intentionality in modern terms (Searle, 2004), up to now it is not referred to the glial networks in the sense of an ontological brain model of subjectivity. Given the role of action cycles in glial-neuronal interactions as elementary volitive processes, the “fundamental desire of any activity is to increase the amount of action experienced and to experience that action in an event-state equilibrium” (Baer, 2019). Since action loops are organized in a hierarchical order, desires generate action programs intending their realization on the behavioral level.

 

2.4 Volitive processes generating realities

 

Volitive processes generating realities work on the action styles of acceptance and rejection enabling the individuum to decide which reality becomes generated selected from a repertoire of possibilities (Mitterauer, 2015). Nonetheless, the possibility to generate a reality depends on the availability of proper subjects and objects in the environment. Principally, an intentional program is striving for its feasibility in the environment. To guarantee individuality information must be structured by rejecting unsuitable information. Günther characterized rejection as the “index of subjectivity” (Günther, 1962). I introduced the action style of rejection into communication theory, since it  frees us not only to reject inappropriate conditions, but also to reject appropriate possibilities. In the latter case volitive processes create a novel reality. Normally, communication is based on an interplay between acceptance and rejection (Mitterauer, 2009; 2013).

 

Experimental findings on motile astrocyte processes may elucidate to volition mechanisms of acceptance and rejection (Hirrlinger et al., 2004). Figure 2 depicts a motile astrocyte process and its function in network structuring (Mitterauer, 2015). A process emanating from the astrocyte body contacts the presynaptic components of the synapse (arrow) and retracts from it (reversed arrow). The rhythmic pulsation of the astrocyte body occurs in minutes, but astrocytic processes activate the synapses in shorter time scales. This mechanism is also responsible for the dynamic construction and destruction of gap junction plaques by adding (bold cycle) and removing (dashed cycle) substances (drawn in cycle) from the gap junction plaques (Morgan and Piccinini, 2018). Gap junctions (GJ) are intercellular channels, which establish cell-cell communication (Dermitzel, 1998).  Here we may deal with intentional programming based on dynamic construction of an embodied program. I suggest that the mechanism of motile astrocytic processes operates on acceptance and rejection on a most elementary level in the brain.


Figure 2. Motile astrocytic processes and network structuring

 

From the pulsating body of the astrocyte processes emanate that either contact (arrow) the pre-post synapse or retract from it (reversed arrow). This mechanism may dynamically structure the gap junction plaque formation in the astroglial network by adding (bold cycle) and removing an embodied cycle (dashed cycle) (Mitterauer, 2015).

 

On the behavioral level intersubjective communication is based on the intentional programs of the subjective subjectivity (“I”) and the objective subjectivity (“You”). The purpose of communication is to program and generate a common action domain of reality. Given that the operations of volitive processes as in the model proposed are undisturbed, communication has to cope with the situation that intentional programs of the partners often differ in one or more aspects. Although differences arise in the dialogue, they are also unconsciously at work (Custers and Aarts, 2010). Notwithstanding, if conscious agreement occurs, communication is co-determined by concealed intentional programs of each partner. For this reason, a sudden break-up of communication, not rationally explainable, can be caused by unconscious intentional programs that reject further communication and make the generation of a common action domain impossible. In this context should be mentioned that the brain model here proposed challenges pure Neurophilosophy that is exclusively based on the functions of the neuronal system (Bennett and Hacker, 2003). As outlined in Figure 1 the brain has a double structure consisting of the neuronal system interpreted as objective subjectivity and the glial system embodying subjective subjectivity. Given that the brain is composed of uncountable glial-neuronal synaptic units each embodying an ontological locus, then we can speak of a polyontological structure of the brain generating many subjective realities (Mitterauer, 2010).

 

2.5 The volition to permanent existence

 

Let us consider again primordial volition to act quantum mechanically described as action cycles that permanently rotate. Biologically speaking, it is the circular organization of a living system that maintains its identity (Maturana, 1970). We proposed a concept of narcissism that is based on the maintenance of the circular organization of an organism upholding its identity as an invariable logic of living systems (Mitterauer, 2003). Significantly, Freud (1913) states that the narcissistic organization is never fully abandoned. I suggest that the logic of narcissism may underlie the volition to permanent existence. Masserman characterized what the essence of narcissism may be: “any human being... has at the basis of his metaphysical system a set of solipsistic formulas to this outstanding effect: “once I was absolute, transcendent and inviolate, and what I was once perhaps I have always been and shall continue to be furthermore.” (Masserman, 1955) Excitingly, Gödel (1995) has computed that materia is permanently rotating.

 

Given the volition to act that works in permanent time, we may feel an unconscious striving for permanent existence (Mitterauer 2014). According to Plato the will to permanent existence and immortality is a fundamental drive of human subjects (Plato, 2006; Taylor, 1927). In the “Ethics of pure will” Cohen states: “the pure will of ethics generates eternity… eternity, detached from time and related to the pure will, means nothing but eternity of progress of ethical work” (Cohen, 1904). Most importantly, Whitehead explicitly refers to the conception of permanence: “as to my own view of permanence and transcendence,  I think the universe has a side which is mental and permanent. This side is that prime conceptual drive which I call the primordial nature of God” (Whitehead, 1947). One can also say that as a metaphysical conception the primordial will is driven by the movement of the soul. This circular (self-referential) movement of the Soul is permanently striving for embodiment with materia, characterized as “the principle of self embodiment of the soul” (Mitterauer, 2018 a,b).

 

Granting, however, the plausibility of the suggested approach to a theory of volition, it must be mentioned that the brain model proposed has to be elaborated within a broader framework of neuron-glial interactions. This basically concerns the controlling functions of astrocytes of homeostasis in neuronal tissue functions (Verkhratsky and Nedergaard, 2018) and the role of calcium waves in the action of feelings (Pereira 2017; 2018).

 

3.  The passion of will in schizophrenia

 

Fundamentally, schizophrenia is a chronic devastating illness. For elucidating the symptoms and the reality experience of patients with schizophrenia, I will focus on dysfunctions of volitive processes in paranoid schizophrenia. Given the various experimentally proven dysfunctions and impairments in brains with schizophrenia, self-instrumentalization is severely affected. The core pathophysiological mechanism can be shown on imbalances in tripartite synapses (Mitterauer, 2014).

 

Figure 3 depicts an unbalanced tripartite synapse responsible for the pathophysiology of paranoid schizophrenia. Non-functional astrocytic receptors (acR, crosses) cannot be activated by neurotransmitters (NT). Since the Ca2+ concentration and the production of gliotransmitters (GT) does not become activated, and gliotransmitters cannot exert a negative feedback on extrasynaptic receptors (esR) and presynaptic receptors (psR) an unconstrained neurotransmission occurs. This leads to a flooding of postsynaptic receptors (poR) by neurotransmitters. In the state of paranoid schizophrenia intentional programs still operate, but the progressive loss of gap junctions (GJ) reduces the domain of intentions (dashed cycle). Since the flux of neurotransmission is unmodulated by the astrocyte, a gap between the sensory information processing in the neuronal network and the “inner” astroglial network exists (Mitterauer 2014; 2019). In spite of the fact that schizophrenia is a chronic devastating process basically caused by the degeneration of astroglia (Verkhratsky et al., 2014), in the first stage of illness mostly delusions and hallucinations prevail.

 


Figure 3. Unbalanced tripartite synapse in paranoid schizophrenia

 

In parallel with the loss of gap junctions (GJ) in the astroglial network, astrocytic receptors (acR) become non-functional (crosses)(1). Therefore, neurotransmitters (NT) cannot activate acR (line with bar), but the activation of the astroglial network continues (2). This leads to minimal concentration of  Ca2+ and production of gliotransmitters (GT). Since GTs exert no feedback on the presynaptic receptors (psR) (dashed line, bar)(3), an unconstrained neurotransmission occurs (4).

 

3.1 The loss of self-boundaries

 

Keromes and colleagues propose that self-other recognition impairments might be a possible endophenotypic trait of schizophrenia (Keromes et al., 2018). The causal role of volitive dysfunctions in the reality experience of patients with paranoid schizophrenia may shed some light on the conception of this endophenotypic trait. Basically, the hidden intentions that staged in delusions and hallucinations cannot be tested by the patient in the environment, but are experienced as real. Though the volition to generate realities operates, the patient is unable to qualify goals, since the self-boundaries are dissolved. As outlined above, the loss of self boundaries is caused by the loss of the astroglial boundary-setting function in tripartite synapses leading to a generalization of information processing as depicted in Figure 4. Given that the astrocytes (Aci, Acj) of compartment x and compartment y have non-functional receptors (asterisks), they cannot influence synaptic information processing. This leads to a compartmentless neuronal network and generalization of information processing, drawn in Figure 4 as a group of eight neurons (N1...N8) completely interconnected by 28 lines (according to the formula n/2 (n-1) (Mitterauer, 2010). Such a brain is incapable of qualitatively structuring environmental information.

 


Figure 4. Loss of the glial boundary-setting function and generalization of information processing in paranoid schizophrenia

 

Astrocytes (Aci; Acj) of compartment x and compartment y have non-functional receptors (asterisks) that cannot influence synaptic information processing. This leads to a compartmentless neuronal network and the generalization of information processing (Mitterauer, 2010).

 

From an ontological point of view, delusions are the consequence of the loss of boundaries between the self and the others. Here, the self is defined as a living system capable of self-observation (Mitterauer, 2007). One could also say that our brain embodies a distinct ontological focus of self-observation. Everything taking place in the brains of schizophrenics is reality, because they cannot differentiate between their inner world and the outer world or the self and the others. Hallucinations may be caused by the same disorder, but the perception systems are phenomenologically affected. If a patient hears the voice of a person in the head, he (she) is absolutely convinced that this person really exists and is speaking to the patient. In this case the loss of ontological boundaries shows its phenomenological manifestation in the auditory system. Such a disorder can also occur in other sensory systems.

 

If the loss of self-boundaries affects the motor system, the symptomatology is called catatonia (Dhossche et al., 2010). A catatonic state in which a disinhibited discharge of nearly all motor systems occurs, is an expression of motoric generalization with raging and screaming as typical phenomena. The opposite phenomenon is motoric immobility, called stupor. Both abnormal behaviors appear to be purposeless and not influenced by external stimuli. In these extreme catatonic states the patient is unable to communicate. Everything that happens, happens in the brain. Here, we can speak of avolition, since only elementary action processes are at work. Affective flattening, a typical negative symptom of schizophrenia (Linder et al., 2016) can also be explained by the loss of the astroglial boundary-setting function. The different affective or emotional qualities cannot be produced in the brain so that the communication of feelings is severely disturbed (Holden, 2003).

Most importantly, if we consider the brain model of schizophrenia here outlined, then schizophrenia is Janus-faced: given that the interaction between the neuronal synapse as the objective part of the synapse and the astrocyte and its networks as the subjective part is interrupted, schizophrenia is an appropriate term. However, since this interruption leads to the generalization of information processing in the brain in the sense of an absolute subjective universe, the term holophrenia (Mitterauer, 2005) may best characterize the reality experience of the patient.

 

3.2 Delusional pseudo-communication and dysintentionality

 

In paranoid schizophrenia the volition to program realities still operates in the glial networks, but the volition  to generate the programmed (intended) realities lacks the goals in the environment, since the patient cannot distinguish between the inner and outer reality. Note, despite the interaction between the neuronal synapse and the astrocyte is interrupted, the activation of the astroglial network by neurotransmitters and ions continues via extrasynaptic neurotransmission (Roux et al., 2011). In this fashion memory structures or intentional programs still work. Especially in scenic delusions the patient generates an inner reality in the sense of a volitive process that is primarily not caused by cognitive impairment. Have schizophrenics an unconscious desire to communicate with others?

 

Frith  suggests that delusions of control involve a failure in action attribution. This could be related to dysfunctions in the intentional binding mechanism and implies the reduced capability of understanding the intentions of others (Frith, 2006). However and decisively, patients suffering from delusions and hallucinations are basically incapable of finding goals for the realization of their intentions in the environment, since they experience themselves ‘holophrenic’ as ‘the universe’. There is no space for intersubjective communication. Most importantly, this is not a-volition or a-motivation, but the inability to realize intentions, called disintentionality (Mitterauer, 2005). Basically, in delusions and hallucinations the destiny for communication becomes staged as ‘pseudo-communication’. This allows the interpretation that in delusions and hallucinations of control the brain is coping with the loss of self-boundaries by generating delusional pseudo-communication. If the patient feels totally controlled by delusions and ‘imperative voices’, this state is best characterized as ‘delusional defenselessness’ (Mitterauer, 2005).

 

3.3 Time experience in schizophrenia: the eternal Now

 

In the perspective of phenomenological psychopathology various interpretations of the time experience of patients with schizophrenia have been proposed, mostly influenced by philosophers such as Husserl, Heidegger or Bergson. Jaspers (1948) characterized the temporal alterations in schizophrenia as “a sudden standstill of time, a loss of continuity between past, present and future”. Ellenberger (1958) suggests that patients with schizophrenia may “feel as if time were fixed at the present moment” underlying delusions of immortality. Importantly, Fuchs and Van Duppen (2017) introduced implicit and explicit time modes that are altered in schizophrenia explanatory for the basic symptoms of the illness. Though implicit time “can be captured by concepts such as drive, striving, urge or affection”, my model of volitive processes may allow the interpretation of the time experience in schizophrenia on a more fundamental level.

 

Given that the primordial volition to act as a permanently rotating cycle is the prime mover of our desires, then we can also speak of a volition to permanent existence on the existential level. Normally, we are aware of our limited lifetime (ontogenetic time), working creatively (evolutive time), and consciously or unconsciously are striving for immortality (Mitterauer, 2009, Plato, 2006). However, in schizophrenia the volition to permanent existence may absolutely determine the reality experience. One of my patients said to me: “ I am the universe and I am the eternity. Do you know how much I am suffering?”  Here we deal with a total generalization of concepts caused by the loss of self-boundaries, driven by the volition to permanent existence and experienced as ‘the eternal Now’.  Moreover, it is decisive to understand why the patient is suffering from this timeless state of the ‘eternal Now’ (Mitterauer, 2003). For the observer it is evident that patients with schizophrenia are burdened by delusions and hallucinations, and their situations in everyday life. However, if we interpret the time experience in schizophrenia as a passion of volition, it is the volition to permanent existence that may fundamentally torture the soul of the patient. Therefore, in addition to the structural and functional impairments of the brain, schizophrenia must be considered as a passion of the soul.

 

4.  Conclusion

 

Based on a psycho-biological brain model a new theory of volition allows the interpretation that schizophrenia is a passion of will. My approach to a deeper understanding of the reality experience of patients suffering from schizophrenia focuses on these five principles of volition: The primordial volition to act; the volition to self-instrumentalize; the volition to program intentions; the volition to generate realities; and the volition to permanent existence (Mitterauer, 2019).

 

Dysfunctions of volitive processes in schizophrenia are fundamentally caused by severe impairments of self-instrumentalization. Because of a gap between sensory information processing in the neuronal networks and the ‘inner’ astroglial networks, the patient is unable to distinguish between the self and the others. From that loss of self boundaries the main symptoms of schizophrenia can be deduced. Although schizophrenia is a chronic devastating illness, in paranoid schizophrenia (delusions and hallucinations) patients are still able to program intentions, but cannot communicate their intentions. Note, this is not a-volition in the sense of a-motivation as generally suggested (Sebanz and Prinz, 2006), but the incapability to realize intentions, called disintentionality. In other words: in delusions the destiny for communication becomes stayed as pseudo-communication.

 

Excitingly, if we consider the pathophysiological model of schizophrenia, schizophrenia is Janus-faced. On the one hand, synaptic information processing is interrupted so that the term schizophrenia is appropriate. On the other hand, the information flux in the neuronal networks is unconstrained generalizing information processing in the brain. In this perspective the connotation of holophrenia may be suitable in the stage of paranoid schizophrenia. Moreover, the time experience is determined by the loss of self-boundaries. Patients with schizophrenia feel their existence as an “eternal Now.” This may indicate that the volition to permanent existence is working deep in the soul of the patient. With all this in mind, the psycho-bio-philosophical model here proposed may enable us to delve deeper in the reality experience and communication pathology of patients suffering from schizophrenia.

 

Acknowledgements:

 

I am grateful to Christian Streili for designing the figures and tables, and Marie Motil for preparing the final version of the paper.

 

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